Isolated malaria outbreak in Somalia: role of chloroquine-resistant Plasmodium falciparum demonstrated in Balcad epidemic

摘要: A study was conducted in Balcad December 1988 during a reported outbreak of malaria order to investigate possible factors contributing the outbreak. The slide positivity rate 71% among fever patients, which significantly higher than usual rate, suggests existence fresh area. High parasite densities together with pronounced symptoms both resident children and adult immigrants indicated little, if any, experience these patients. This could not be explained by gross climatic changes, e.g. unusual rainfalls. in-vivo response P. falciparum standard therapeutic regimen chloroquine showed high degree resistance, 31 36 patients showing including five RI responses 26 RII-RIII responses. Micro in-vitro tests for susceptibility resistance 33 out 37 isolates mean EC50 EC99 1.50 10.97 X 10(-6) mol l-1 blood, respectively, indicative resistance. All tested against sulphadoxine/pyrimethamine sensitive response. frequent presence (78%) detectable levels prior treatment did apparently alter growth. is sign widespread use this drug resulting 'drug pressure' proportion parasites inversely related pretreatment concentration providing evidence selection resistant previous intake.(ABSTRACT TRUNCATED AT 250 WORDS)