Sensitivity of Plasmodium falciparum to antimalarial drugs in Hainan Island, China.
Pyronaridine and artesunate have been shown to be effective in falciparum malaria treatment. However, pyronaridine is rarely used in Hainan Island clinically, and artesunate is not widely used as a therapeutic agent. Instead, conventional antimalarial drugs, chloroquine and piperaquine, are used, explaining the emergence of chloroquine-resistant Plasmodium falciparum. In this article, we investigated the sensitivity of P. falciparum to antimalarial drugs used in Hainan Island for rational drug therapy. We performed in vivo (28 days) and in vitro tests to determine the sensitivity of P. falciparum to antimalarial drugs. Total 46 patients with falciparum malaria were treated with dihydroartemisinin/piperaquine phosphate (DUO-COTECXIN) and followed up for 28 day. The cure rate was 97.8%. The mean fever clearance time (22.5 ± 10.6 hr) and the mean parasite clearance time (27.3 ± 12.2 hr) showed no statistical significance with different genders, ages, temperatures, or parasite density (P > 0.05). The resistance rates of chloroquine, piperaquine, pyronarididine, and artesunate detected in vitro were 71.9%, 40.6%, 12.5%, and 0%, respectively (P < 0.0001). The resistance intensities decreased as follows: chloroquine > piperaquine > pyronarididine > artesunate. The inhibitory dose 50 (IC50) was 3.77 × 10(-6) mol/L, 2.09 × 10(-6) mol/L, 0.09 × 10(-6) mol/L, and 0.05 × 10(-6) mol/L, and the mean concentrations for complete inhibition (CIMC) of schizont formation were 5.60 × 10(-6) mol/L, 9.26 × 10(-6) mol/L, 0.55 × 10(-6) mol/L, and 0.07 × 10(-6) mol/L, respectively. Dihydroartemisinin showed a strong therapeutic effect against falciparum malaria with a low toxicity.
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Shan-Qing
SQ
Wang
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Guang-Ze
GZ
Wang
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Yu-Chun
YC
Li
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Feng
F
Meng
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Shi-Gan
SG
Lin
Haikou Center for Disease Control and Prevention, Haikou, 571100, China.
Zhen-Hu
ZH
Zhu
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Ding-Wei
DW
Sun
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Chang-Hua
CH
He
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Xi-Min
XM
Hu
Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, China.
Jian-Wei
JW
Du
D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000494:pharmacology* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D006801:Humans; D020128:Inhibitory Concentration 50; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D021261:Parasitic Sensitivity Tests; D010963:Plasmodium falciparum / Q000187:drug effects*; D016896:Treatment Outcome; D055815:Young Adult
D000962:Antimalarials
Plasmodium falciparum; antimalarial; in vivo and in vitro test; sensitivity