Monitoring the efficacy of antimalarial medicines in India via sentinel sites: Outcomes and risk factors for treatment failure.

摘要: Background & objectives To combat the problem of antimalarial drug resistance, monitoring changes in efficacy over time through periodic surveillance is essential. Since 2009, systematic and continuous being done nationwide sentinel site system. Potential early warning signs like partner resistance markers were also monitored clinical samples from study areas. Methods A total 1864 patients with acute uncomplicated malaria enrolled therapeutic studies artesunate plus sulphadoxine-pyrimethamine (AS+SP) for Plasmodium falciparum; those infected P. vivax given chloroquine (CQ). Polymerase chain reaction (PCR) was used to distinguish post-treatment reinfection treatment failures. Isolates falciparum analysed dihydropteroate synthase (dhps) dihydrofolate reductase (dhfr) gene mutations. Results Overall, 1687 (91.7%) completed follow-up. In most parasitaemia cleared within 24 h treatment, except 12 who remained parasite positive after 72 h. Presence dhfr dhps quintuple mutation observed predominantly failure samples. daily dose 95% cases all sites Northeastern region (NE). Chloroquine 100% efficacious case infections. Interpretation conclusion Till 2012, India's national system proved highly safe towards first-line antimalarials country, where a decline AS+SP has been observed. This led change artemether-lumefantrine region.