Resistance of Plasmodium falciparum to antimalarial drugs in a highly endemic area of southern Viet Nam: a study in vivo and in vitro.

摘要: To assess the antimalarial sensitivity of Plasmodium falciparum in vivo and vitro a highly endemic area southern Viet Nam, field study was conducted (in 1999) at rubber plantation Binh Phuoc Province north Ho Chi Minh City. Fifty patients were treated with either artesunate (4 mg/kg on day 0, then 2 1 to 4) or mefloquine (10 0 h, 5 6 h), their progress followed for 28 days under standard WHO protocols. Blood spots taken baseline from all patients, as well those who redeveloped parasitaemia during follow-up, polymerase chain reaction (PCR) determination parasite genotypes assist differentiation re-infection recrudescence. Both treatments cleared parasites within days. Of 25 mefloquine-treated (8%) re-presented probable re-infections. For artesunate, 4 (16%) had re-infections (20%) recrudescences. Sensitivity tests pre-treatment P. isolates showed geometric mean IC50 values 29, 38, 209 15 nmol/L chloroquine (n = 32), 33), quinine 31) artemisinin 31), respectively. There significant correlations between IC50s (r 0.72, P 0.004), 0.44, 0.05). These data show that, although has been used 10 years Province, it remains fully effective, perhaps because an derivative is commonly given same time. The recrudescence rate similar reported other epidemiological contexts. present in-vitro imply that effective reduced drug pressure associated increased local strains chloroquine. Although one hyperendemic area, these results may have implications prophylaxis treatment strategies residents travellers Nam.