Elsevier

The Lancet

Volume 360, Issue 9326, 6 July 2002, Pages 58-60
The Lancet

Research Letters
Chloroquine-resistant Plasmodium malariae in south Sumatra, Indonesia

https://doi.org/10.1016/S0140-6736(02)09336-4Get rights and content

Summary

Oral chloroquine is the treatment of choice for uncomplicated Plasmodium malariae infections worldwide. We did a prospective 28-day in-vivo assessment of the efficacy of chloroquine for treatment of P malariae on Legundi Island in Lampung Bay, Sumatra, Indonesia. Of 28 patients, one had recurrent parasitaemia on day 28, and two had persistent parasitaemia to day 8. Whole-blood chloroquine and desethylchloroquine concentrations were at ordinarily effective levels (⩾100 μg/L) on day 8 in both cases of persistent parasitaemia. These findings suggest that clinical resistance to chloroquine by P malariae occurs in the Indonesian archipelago of southeast Asia.

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    Citation Excerpt :

    Moreover, the failing chemotherapeutics against the acute attack (Collins and Roberts, 1991; Yohannes et al., 2011) and inadequacy of the only available therapy against relapse (Taye et al., 2006) add further complexity and worrisome to the control and elimination of this parasite species from many vivax malaria-endemic settings. To date, parasite resistance has been documented in three of the five malaria species known to affect humans: P. vivax, P. falciparum, and Plasmodium malariae (Rieckmann et al., 1989; Wellems and Plowe, 2001; Price and Nosten, 2001; Maguire et al., 2002; Vestergaard and Ringwald, 2007). During the past decades, several highly efficacious anti-malarials such as chloroquine (CQ) had to be removed from markets after the development of parasite resistance to these drugs.

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