Chloroquine- And Sulfadoxine-Pyrimethamine-Resistant Falciparum Malaria in Vivo - A Pilot Study in Rural Zambia

Trop Med Int Health. 2000 Oct;5(10):692-5. doi: 10.1046/j.1365-3156.2000.00629.x.

Abstract

Background: Chloroquine (CQ) and Sulfadoxine-Pyrimethamine (SP) are the predominantly used antimalarials in Zambia and other parts of East Africa, but increasing resistance of P. falciparum is a major concern.

Methods: Seventy consecutive patients with uncomplicated falciparum malaria were enrolled. In 43 patients, no prior CQ use could be demonstrated by history and urianalysis (qualitative test, Dill & Glazko) and these patients were given CQ; the other 27 had taken CQ before and received SP.

Results: Combined R-II and R-III CQ-resistance was 58% (60% in under-fives), which is the range previously reported from Zambia. By contrast, SP-resistance (R-II and R-III) was much higher (26%) than previously reported (3% - 17%). The history of prior CQ intake correlated well with the results of the Dill-Glazko test; there was no evidence for prior SP intake to explain these results.

Conclusion: If our findings of SP resistance are confirmed, other drugs such as quinine, atovaquone/proguanil and artemisinin are required to treat malaria in Zambia.

MeSH terms

  • Animals
  • Antimalarials / pharmacology*
  • Antimalarials / therapeutic use
  • Child, Preschool
  • Chloroquine / pharmacology*
  • Chloroquine / therapeutic use
  • Drug Combinations
  • Drug Resistance
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Malaria, Falciparum / drug therapy*
  • Male
  • Pilot Projects
  • Plasmodium falciparum / drug effects*
  • Plasmodium falciparum / growth & development
  • Pyrimethamine / pharmacology*
  • Pyrimethamine / therapeutic use
  • Rural Health
  • Sulfadoxine / pharmacology*
  • Sulfadoxine / therapeutic use
  • Zambia

Substances

  • Antimalarials
  • Drug Combinations
  • fanasil, pyrimethamine drug combination
  • Sulfadoxine
  • Chloroquine
  • Pyrimethamine