Chloroquine-resistant Plasmodium falciparum in Eastern Sudan

Bayoumi, Riad; Babiker, Hamza A.; Ibrahim, Shaimaa S.; Ghalib, H. W.; Saeed, B. O.; Khider, S.; Elwasila, Mohamed; Karim, Enamul

doi:10.1016/0001-706x(89)90032-6

Cited by 45 publications

(31 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These resistance levels are considerably higher than earlier reports from Uganda, 28,29 but consistent with the 58% risk of parasitological resistance more recently reported from an urban Ugandan setting 30 and reports of resistance from countries neighboring Uganda. [1][2][3][4][5][6][7] Our study identified simple host-related characteristics that were independent predictors of chloroquine treatment failure. Young age was a strong predictor of treatment failure.…”

Section: Discussionmentioning

confidence: 99%

“…Resistance levels have risen alarmingly over the last 20 years, and in recent studies chloroquine has failed to clear parasites in up to 80% of EastAfrican patients. [1][2][3][4][5][6][7] Chloroquine resistance has also been linked to increased malaria-specific mortality. 8 Despite the spread of resistance, most African countries continue to designate chloroquine as the first-line drug for uncomplicated malaria.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of chloroquine treatment failure in children and adults with falciparum malaria in Kampala, Uganda.

Dorsey

Kamya²,

Ndeezi³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Chloroquine-resistant falciparum malaria is a serious problem in much of sub-Saharan Africa. However, it is desirable to continue to use chloroquine as first-line therapy for uncomplicated malaria where it remains clinically effective. To identify predictors of chloroquine treatment failure, a 14-day clinical study of chloroquine resistance in patients with uncomplicated falciparum malaria was performed in Kampala, Uganda. Among the 258 patients (88% follow-up), 47% were clinical failures (early or late treatment failure) and 70% had parasitological resistance (RI-RIII). Using multivariate analysis, an age less than five (odds ratio [OR] ϭ 3.4, 95% CI ϭ 1.8-6.3) and a presenting temperature over 38.0ЊC (OR ϭ 2.0, 95% CI ϭ 1.1-3.7) were independent predictors of treatment failure. In addition, patients who last took chloroquine 3 to 14 days prior to study entry were significantly more likely to be treatment failures compared to patients with very recent (less than 3 days) or no recent chloroquine use. In areas with significant chloroquine resistance, easily identifiable predictors of chloroquine treatment failure might be used to stratify patients into those for whom chloroquine use is acceptable and those for whom alternative treatment should be used.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of chloroquine treatment failure in children and adults with falciparum malaria in Kampala, Uganda.

Dorsey

Kamya²,

Ndeezi³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…Some studies showed that in five hospitals of central Sudan, 85.6% of patients admitted for severe malaria had received CQ before admission 22 and that CQ was also the commonly prescribed drug by health care providers. 23 First cases of CQ resistance were reported in 1978, 24 and several in vivo and in vitro studies have subsequently documented a high presence of CQ resistance in different Sudanese areas (central Sudan [25][26][27] ; eastern Sudan 28,29 ). Sulfadoxine/pyrimethamine resistance was reported in Sudan since the early 1990s 30 and was documented by in vivo studies conducted in eastern Sudan just before ACT deployment.…”

Section: Introductionmentioning

confidence: 99%

Frequency Distribution of Antimalarial Drug Resistance Alleles among Plasmodium falciparum Isolates from Gezira State, Central Sudan, and Gedarif State, Eastern Sudan

Menegon

Talha²,

Severini³

et al. 2010

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

In 2004, Sudan adopted artesunate + sulfadoxine/pyrimethamine (SP) combination as the first-line drug, in response to the high level of falciparum resistance to antimalarials. In 2007, a molecular study on antimalarial resistance linked genes, pfcrt, pfmdr1, pfdhfr, pfdhps, and pfATPase6, was conducted on 198 isolates from central and eastern Sudan. We observed a high frequency of point mutations at almost all loci analyzed, mainly of pfcrt 76T (72.7%), pfdhfr 51I (75.3%), and pfdhfr 108N (72.7%) alleles. The MARK III in vitro test for chloroquine sensitivity in 45 P. falciparum isolates showed that 37.8% of the isolates were low resistant and 6.7% were fully resistant. This study represents the most recent molecular investigation on antimalarial resistance in this area after the adoption of artemisinin-based combination therapy (ACT), and underlines the importance of the analysis of SP resistance evolution to monitor the efficacy of ACT therapy in endemic areas.

show abstract

“…Although CQ failure proportions seemed higher than the figures reported by the routine Chadian surveillance system, these results were not surprising. A lower efficacy (58.5%) was already reported in neighbouring Nigeria (Sowunmi et al, 2001) and was extensively reported in many other sub-Saharan countries (Bayoumi et al, 1989;Checchi et al, 2002;Talisuna et al, 2002).…”

Section: Discussionmentioning

confidence: 71%

“…Resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) has reached high levels in many sub-Saharan countries from Eastern Africa (Bayoumi et al, 1989;Rønn et al, 1996;Talisuna et al, 2002;Terlouw et al, 2003) to Western Africa (Checchi et al, 2002;Ekanem et al, 1990;Sowunmi et al, 2001). This phenomenon has led to an increase in disease-specific morbidity and mortality (Marsh, 1998;Trape, 2001), and the lack of efficacious and affordable treatments has severely constrained the public health response in many countries.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of chloroquine, sulfadoxine–pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad

Grandesso¹,

Bachy²,

Donam

et al. 2006

Transactions of the Royal Society of Tropical Medicine and Hygi

View full text Add to dashboard Cite

CitationEfficacy of chloroquine, sulfadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad. 2006 a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r h e a l t h . c o m / j o u r n a l s / t r s t SummaryWe report two 28-day in-vivo antimalarial efficacy studies carried out in the urban centres of Bongor and Koumra, southern Chad. We assess chloroquine (CQ), sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) to treat Plasmodium falciparum uncomplicated malaria. Methods and outcome classification complied with latest WHO guidelines. Out of the 301 and 318 children aged 6−59 months included in Bongor and Koumra, respectively, 246 (81.7%) and 257 (80.8%) were eligible for analysis. In Bongor and Koumra, the 28-day PCR-adjusted failure rates for CQ were 23.7% (95% CI 14.7-34.8%) and 32.9% (95% CI 22.1-45.1%), respectively, and those for SP were 16.3% (95% CI 9.4-25.5%) and 4.3% (95% CI 1.2-10.5%). AQ failure rates were 6.4% (95% CI 2.1-14.3%) and 2.2% (95% CI 0.3-7.6%). The current use of CQ in Bongor and Koumra is questionable, and a more efficacious treatment is needed. Considering the reduced efficacy of SP in Bongor, AQ seems to be the best option for the time being. Following WHO recommendations that prioritize the use of artemisinin-based combinations, artesunate plus amodiaquine could be a potential

show abstract

Chloroquine-resistant Plasmodium falciparum in Eastern Sudan

Cited by 45 publications

References 5 publications

Predictors of chloroquine treatment failure in children and adults with falciparum malaria in Kampala, Uganda.

Predictors of chloroquine treatment failure in children and adults with falciparum malaria in Kampala, Uganda.

Frequency Distribution of Antimalarial Drug Resistance Alleles among Plasmodium falciparum Isolates from Gezira State, Central Sudan, and Gedarif State, Eastern Sudan

Efficacy of chloroquine, sulfadoxine–pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad

Contact Info

Product

Resources

About