Pyrimethamine-sulfadoxine still effective against Plasmodium falciparum in Jayapura, Irian Jaya: RI-type resistance in 2 of 18 patients

Hoffman, Stephen L.; Campbell, James; Rustama, Diet; Dimpudus, Anthony J.; Surumpaet, Binsar; Rüsch, Jan; Marwoto, Harijani A.

doi:10.1016/0035-9203(87)90240-9

Cited by 9 publications

(8 citation statements)

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“…All 50 chloroquine-resistant samples carried the mutant pfcrt 76T allele. No mutation was detected at codon 73, but variations were found at codons 72, 74, and 75 in 50 samples: SVMNT (24), CVIET (11), CVMNT (9), and SVIET (6). Statistical analysis (chi-square test with Yates' correction) showed that the pfcrt mutation at codon 76 was strongly associated with chloroquine resistance (P < 0.0001).…”

Section: Resultsmentioning

confidence: 96%

“…4,5 An increased risk of chloroquine resistance was reported from the Jayapura region of Papua, Indonesia in the1980s. 6,7 Surveys conducted during the 1990s showed high malaria prevalence rates (60−92%) and levels of chloroquine treatment failure of up to 80% among indigenous and immigrant communities of northern and central Papuan Indonesia. 8−12 However, due to its safety profile, low cost, and relative success in treating mildly symptomatic malaria infections among immune and semi-immune patients, chloroquine remains the treatment of choice for malaria, and no effective alternative strategy has been developed.…”

Section: Introductionmentioning

confidence: 99%

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New Haplotypes of the Plasmodium Falciparum Chloroquine Resistance Transporter (Pfcrt) Gene Among Chloroquine-Resistant Parasite Isolates

Nagesha¹,

Casey²,

Rieckmann³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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Mutations in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) gene were examined to assess their associations with chloroquine resistance in clinical samples from Armopa (Papua) and Papua New Guinea. In Papua, two of the five pfcrt haplotypes found were new: SVIET from Armopa and CVIKT from an isolate in Timika. There was also a strong association (P < 0.0001) between the pfcrt 76T allele and chloroquine resistance in 50 samples. In Papua New Guinea, mutations in the pfcrt gene were observed in 15 isolates with chloroquine minimum inhibitory concentrations (MICs) of 16−64 pmol, while the remaining six isolates, which had a wild-type pfcrt gene at codon 76, had MICs of 2−8 pmol. These observations confirm that mutations at codon 76 in the pfcrt gene are present in both in vivo and in vitro cases of chloroquine resistance, and that detection of the pfcrt 76T allele could predict potential chloroquine treatment failures.

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Section: Resultsmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

New Haplotypes of the Plasmodium Falciparum Chloroquine Resistance Transporter (Pfcrt) Gene Among Chloroquine-Resistant Parasite Isolates

Nagesha¹,

Casey²,

Rieckmann³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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“…29,30 With the exception of one study conducted in Papua (formerly Irian Jaya), where SP treatment failure rates were greater than 50%, 31 the SP treatment success rate observed in this trial is similar to that observed in other SP treatment trials conducted in eastern Indonesia. [32][33][34] In western Indonesia, rea-sonably good efficacy is reported for SP in central Java (78% treatment success at day 28) 35 which contrasted dramatically with a 83% failure rate observed for SP treatment of uncomplicated P. falciparum malaria in Nias Island in northern Sumatra. 36 The success of antimalarial treatment is influenced by many factors.…”

Section: Discussionmentioning

confidence: 98%

Comparative Efficacy of Chloroquine and Sulfadoxine-Pyrimethamine for Uncomplicated Plasmodium Falciparum Malaria and Impact on Gametocyte Carriage Rates in the East Nusatenggara Province of Indonesia

Sutanto

Supriyanto²,

Purnomo³

et al. 2004

The American Journal of Tropical Medicine and Hygiene

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The efficacy of chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) was evaluated in 89 subjects greater than one year of age with uncomplicated P. falciparum malaria in the East Nusatenggara Province of Indonesia. Fever clearance time was longer in the SP group than in the CQ group. However, parasite clearance time was extended in subjects who received CQ compared with those who received SP. Major adverse events were not observed in either group, and no hospitalizations were required during the study. Treatment failure rates at day 28 were 69% for CQ and 8.5% for SP. In both treatment groups, gametocytemia developed during the follow-up period, but was more pronounced in the SP group, peaking at 94% on day 7. Regardless of treatment group, children < 10 years of age had significantly higher treatment failure rates than subjects >/=10 years of age (relative risk = 2.49), suggesting that acquired immunity influenced treatment outcomes in the presence of parasite drug resistance. Although a highly effective alternative to CQ for clearing infection, SP treatment also presented some potential drawbacks (e.g., increased and persistent gametocytemia). Replacement of CQ with SP as a first-line therapy, either alone or in combination with CQ, in those areas of Indonesia with high levels of CQ resistance should significantly improve treatment outcomes, particularly in vulnerable populations lacking clinical immunity. More efficacious and rapidly acting asexual stage treatments are generally associated with increased gametocyte clearance and combination therapy in areas where drug resistance is high or emerging may provide an additional means for reducing transmission.

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“…Rumans et al first reported P. falciparum resistance to SP in 1979 in Jayapura (Papua; Rumans et al, 1979). Since then, Hoffman et al have conducted tests in Jayapura (Papua), revealing resistance in 5% (2/41) and 11% (2/18) of cases, in 1983 and 1984, respectively (Hoffman et al, 1985, 1987).…”

Section: 2 Epidemiology Of Malariamentioning

confidence: 99%

Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

Elyazar

Hay

Baird

2011

Advances in Parasitology

142

155

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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...

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Pyrimethamine-sulfadoxine still effective against Plasmodium falciparum in Jayapura, Irian Jaya: RI-type resistance in 2 of 18 patients

Cited by 9 publications

References 5 publications

New Haplotypes of the Plasmodium Falciparum Chloroquine Resistance Transporter (Pfcrt) Gene Among Chloroquine-Resistant Parasite Isolates

New Haplotypes of the Plasmodium Falciparum Chloroquine Resistance Transporter (Pfcrt) Gene Among Chloroquine-Resistant Parasite Isolates

Comparative Efficacy of Chloroquine and Sulfadoxine-Pyrimethamine for Uncomplicated Plasmodium Falciparum Malaria and Impact on Gametocyte Carriage Rates in the East Nusatenggara Province of Indonesia

Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

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