Efficacy of existing antimalarial drugs for uncomplicated malaria in Timika, Papua, Indonesia

Siswantoro, Hadjar; Ratclif, A.; Kenangalem, Enny; Wuwung, M.; Maristela, R.; Rumaseuw, R; Laihad, Ferdinand; Ebsworth, Peter; Anstey, NM; Price, Ric N.; Tjitra, Emiliana

doi:10.13181/mji.v15i4.243

Cited by 6 publications

(14 citation statements)

References 12 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, no standard definition of resistance supported that diagnosis, and it remains at least possible (although perhaps unlikely) that CQ-sensitive asexual blood stages may persist to the eighth day post-therapy, by virtue of the longer asexual cycle of development in this parasite, that is, the 36-h cycle of P. vivax versus the 48-h cycle of P. falciparum malaria. However, Siswantoro et al made different findings during research conducted in Timika (Papua) in 2005 (Siswantoro et al, 2006). They evaluated the efficacy of CQ in treating 50 patients infected by P. malariae and followed their progress over 28 days.…”

Section: 2 Epidemiology Of Malariamentioning

confidence: 99%

“…Siswantoro et al evaluated the efficacy of CQ as a treatment in 14 subjects with P. ovale malaria in Timika (Papua; Siswantoro et al, 2006). They found that there were no recurrences within 28 days following treatment.…”

Section: 2 Epidemiology Of Malariamentioning

confidence: 99%

“… Lesser Sundas : (Fryauff et al, 1997b; Gundelfinger et al, 1975; Hanna, 1993; McCullough et al, 1993; Nurhayati, 2003; Sutanto et al, 2009). Papua : (Asih, 2010; Baird et al, 1991a, 1995a, 1997a, 1997b; Fryauff et al, 1999; Murphy et al, 1993; Siswantoro et al, 2006; Sumawinata et al, 2003; Taylor et al, 2001). …”

Section: Figure 21mentioning

confidence: 99%

See 2 more Smart Citations

Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

Elyazar

Hay

Baird

2011

Advances in Parasitology Volume 74

135

155

View full text Add to dashboard Cite

Approximately 230 million people live in Indonesia. The country is also home to over 20 anopheline vectors of malaria which transmit all four of the species of Plasmodium that routinely infect humans. A complex mosaic of risk of infection across this 5000-km-long archipelago of thousands of islands and distinctive habitats seriously challenges efforts to control malaria. Social, economic and political dimensions contribute to these complexities. This chapter examines malaria and its control in Indonesia, from the earliest efforts by malariologists of the colonial Netherlands East Indies, through the Global Malaria Eradication Campaign of the 1950s, the tumult following the coup d'état of 1965, the global resurgence of malaria through the 1980s and 1990s and finally through to the decentralization of government authority following the fall of the authoritarian Soeharto regime in 1998. We detail important methods of control and their impact in the context of the political systems that supported them. We examine prospects for malaria control in contemporary decentralized and democratized Indonesia with multidrug-resistant malaria and greatly diminished capacities for integrated malaria control management programs. INTRODUCTIONEach year Indonesia's 230 million people collectively suffer at least several million cases of malaria caused by all four known species of human Plasmodium. Despite a long history of pioneering work in malaria prevention, treatment and control reaching back to the early 1900s, no systematic review of malaria in Indonesia has yet been undertaken. This chapter attempts to remedy this with a detailed examination of the genesis, nature and outcome of control strategies, along with a comprehensive review of peer-reviewed and published work on malaria. We also examine contemporary malaria in the context of government systems arrayed against it. This article does not include the body of knowledge on the complex array of anopheline vectors of malaria found in Indonesia. That topic is reserved for a separate review.© 2011 Elsevier Ltd. All rights reserved. Author contributions: I. R. F. E. compiled malaria parasite rate data and antimalarial drug susceptibility test data. I. R. F. E. wrote the first draft of the chapter. J. K. B. and S. I. H. commented on the final draft of chapter. Fig. 2.1). The country consists of 17,504 islands (only 6000 of which are inhabited), covering a land area of 1.9 million km 2 (Departemen Dalam Negeri, 2004. The archipelago comprises seven main islands: Sumatra, Java, Kalimantan, Sulawesi, Maluku, the Lesser Sundas and Papua. Since decentralization of government power in 2000, Indonesia has been considered to consist of 33 provinces, 465 districts/municipalities, 6093 sub-districts and 73,067 villages . Census authorities in 2007 estimated a population of 227 million people, with an average density of 118 people/km 2 . The annual population growth rate was 1.3% (Badan Pusat Statistik, 2007a). The population density on Java and Bali (977 people/km 2 ) was much hig...

show abstract

Section: 2 Epidemiology Of Malariamentioning

confidence: 99%

Section: 2 Epidemiology Of Malariamentioning

confidence: 99%

See 1 more Smart Citation

Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

Elyazar

Hay

Baird

2011

Advances in Parasitology Volume 74

135

155

View full text Add to dashboard Cite

show abstract

“…In southern Papua, Indonesia, where high-grade drug resistance has emerged to infection by both P. falciparum and P. vivax (33,37), we have conducted a series of drug trials to optimize treatment strategies (15,32). In 2004 and 2005, patients who failed treatment for recurrent P. vivax infections were treated again, this time with amodiaquine monotherapy, and their clinical responses were documented.…”

mentioning

confidence: 99%

In Vivo and In Vitro Efficacy of Amodiaquine Monotherapy for Treatment of Infection by Chloroquine-Resistant Plasmodium vivax

Hasugian

Tjitra

Ratcliff

et al. 2009

Antimicrob Agents Chemother

Self Cite

View full text Add to dashboard Cite

Amodiaquine retains efficacy against infection by chloroquine-resistant Plasmodium falciparum; however, little information is available on its efficacy against infection by chloroquine-resistant Plasmodium vivax. Patients presenting to a rural clinic with a pure P. vivax infection that recurred after recent antimalarial treatment were retreated, this time with amodiaquine monotherapy, and the risk of further recurrence within 4 weeks was assessed. Of the 87 patients with pure P. vivax infection, 15 patients did not complete a full course of treatment, 4 of whom were intolerant to treatment. In the 72 patients completing treatment, 91% (63 of 69) had cleared their parasitemia within 48 h with no early treatment failure. Follow-up to day 28 or recurrent parasitemia was achieved for 56 patients (78%). The cumulative incidence of treatment failure by day 28 was 22.8% (95% confidence interval, 7.3 to 38%). The in vitro sensitivity profile was determined for a separate set of isolates from outpatients with pure P. vivax infection. The median 50% inhibitory concentration of amodiaquine was 11.3 nM (range, 0.37 to 95.8) and was correlated significantly with that of chloroquine (Spearman rank correlation coefficient, 0.602; P < 0.001). Although amodiaquine results in a rapid clinical response, the risk of recurrence by day 28 is unacceptably high, reducing its suitability as an alternative treatment of infection by chloroquine-resistant P. vivax in this region.

show abstract

“…This region is unusual in harboring high levels of drug resistance in both of these species; treatment failure within 28 days exceeds 65% after chloroquine (CQ) monotherapy for P. vivax and 48% after chloroquine plus sulfadoxine plus pyrimethamine for P. falciparum (7,16,21). The high levels of chloroquine resistance in P. falciparum and P. vivax, coupled with previous observations of potential drug-resistant strains of P. malariae in western Indonesia (10), raised concerns that chloroquine resistance might also be emerging in P. malariae and P. ovale.…”

mentioning

confidence: 99%

In Vivo and In Vitro Efficacy of Chloroquine against Plasmodium malariae and P. ovale in Papua, Indonesia

Siswantoro

Russell

Ratcliff

et al. 2011

Antimicrob Agents Chemother

Self Cite

View full text Add to dashboard Cite

Reports of potential drug-resistant strains ofPlasmodium malariaein western Indonesia raise concerns that chloroquine resistance may be emerging inP. malariaeandP. ovale. In order to assess this,in vivoandin vitroefficacy studies were conducted in patients with monoinfection in Papua, Indonesia. Consecutive patients with uncomplicated malaria due toP. ovaleorP. malariaewere enrolled in a prospective clinical trial, provided with supervised chloroquine treatment, and followed for 28 days. Blood from patients withP. malariaeorP. ovaleparasitemia greater than 1,000 per microliter underwentin vitroantimalarial drug susceptibility testing using a modified schizont maturation assay. Of the 57 evaluable patients in the clinical study (P. malariae,n= 46;P. ovale,n= 11), none had recurrence with the same species during follow-up. The mean parasite reduction ratio at 48 h was 86 (95% confidence interval [CI], 57 to 114) forP. malariaeand 150 (95% CI, 54 to 245) forP. ovale(P= 0.18). One patient infected withP. malariae, with 93% of parasites at the trophozoite stage, was still parasitemic on day 4.In vitrodrug susceptibility assays were carried out successfully for 40 isolates (34 infected withP. malariaeand 6 withP. ovale). TheP. malariaeinfections at trophozoite stages had significantly higher chloroquine 50% effective concentrations (EC50s) (median, 127.9 nM [range, 7.9 to 2,980]) than those initially exposed at the ring stage (median, 14.0 nM [range, 3.5 to 27.0];P= 0.01). The EC50for chloroquine inP. ovalewas also higher in an isolate initially at the trophozoite stage (23.2 nM) than in the three isolates predominantly at ring stage (7.8 nM). Chloroquine retains adequate efficacy againstP. ovaleandP. malariae, but its marked stage specificity of action may account for reports of delayed parasite clearance times.

show abstract

Efficacy of existing antimalarial drugs for uncomplicated malaria in Timika, Papua, Indonesia

Cited by 6 publications

References 12 publications

Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

In Vivo and In Vitro Efficacy of Amodiaquine Monotherapy for Treatment of Infection by Chloroquine-Resistant Plasmodium vivax

In Vivo and In Vitro Efficacy of Chloroquine against Plasmodium malariae and P. ovale in Papua, Indonesia

Contact Info

Product

Resources

About