Is Plasmodium Falciparum Resistance to Chloroquine Reversible in Absence of Drug Pressure?

Onori, E.; Phan, Vu Thi

doi:10.1016/s0140-6736(86)90846-9

Cited by 9 publications

(1 citation statement)

References 3 publications

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“…In 2001, 82 cases from the Yaliang Township of Sanya City were examined by the in vitro microtest; the results indicated that the mean drug concentration for complete inhibition of schizont maturation was 3.56 pmol/μl blood and in 12.5% cases, it was >6.4 pmol/μl blood. In 2003, 16 cases from the Fubao Township of Ledong County were examined by the in vivo four-week test; the results indicated that the asexual parasite clearance time in the blood was an average of 56.9 hours and the percentage of RIII cases was 20%, indicating that the degree of the chloroquine resistance of P. falciparum reduced gradually after the use of chloroquine was stopped [22-26]. …”

Section: Reviewmentioning

confidence: 99%

Surveillance of antimalarial drug resistance in China in the 1980s–1990s

Liu

2014

Infect Dis Poverty

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Since the successful preparation of the microplates and the medium for field application, the resistance degree and its geographical distribution of chloroquine-resistant Plasmodium falciparum, the fluctuation of the resistance degree of P. falciparum to chloroquine, and the sensitivity of the parasite to commonly used antimalarial drugs were investigated between 1980 and 2003 by the in vitro microtest and the in vivo four-week test recommended by the World Health Organization (WHO). The results indicated that chloroquine-resistant falciparum malaria was present in all eight provinces/autonomous regions endemic for falciparum malaria in China, and the resistance was high and widely distributed in the Hainan and Yunnan provinces. When the use of chloroquine was stopped or administered in a decreased quanity, the drug resistance gradually decreased. In Hainan and Yunnan, P. falciparum was still highly resistant to chloroquine, amodiaquine and piperaquine, and sensitive to pyronaridine and artemisinin derivatives, but the sensitivity was gradually reduced. Based on these results, principles and therapeutic regimens for antimalarial drug use in China were formulated, the use of the antimalarials which had already developed resistance was stopped or reduced, and recommendations to use artemisinin derivatives or compound pyronaridine to promote a rational use of antimalarials and strengthen malaria control were made. The results showed that malaria incidence had declined, and endemic areas of falciparum malaria have been gradually reducing since the mid-1980s.

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Section: Reviewmentioning

confidence: 99%

Surveillance of antimalarial drug resistance in China in the 1980s–1990s

Liu

2014

Infect Dis Poverty

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Plasmodium falciparum Infection and the Other Human Malarias

Cook

1990

Parasitic Disease in Clinical Practice

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Triple Combination Therapy and Drug Cycling—Tangential Strategies for Countering Artemisinin Resistance

Bhattacharjee

Shivaprakash

Balaji

2017

Curr Infect Dis Rep

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Recent reports have suggested that increasing the heterogeneity within the parasite's environment, both at an individual and the population level, may help raise the probabilistic barrier of development of resistance in the parasite. The encouraging results following the implementation of a few experimental triple combination therapies like atovaquone-proguanil-artesunate along with the re-emergence of chloroquine sensitive Plasmodium falciparum parasites in the sub-Saharan African nations have re-kindled mankind's hope of curbing anti-malarial drug resistance. The addition of a third drug with traits like a medium half-life and benign safety profile is crucial to achieving SERCAP (single encounter radical cure and preventive therapy), the principle of a triple combination therapy. Simultaneously, the plausible reasons behind the re-emergence of chloroquine sensitive Plasmodium falciparum malaria in the high transmission regions could be the re-expansion of an existing chloroquine susceptible parasite reservoir and a greater predisposition towards the development of polyclonal infections. Another potential reason for this observation could be an impaired deoxyribonucleic acid (DNA) repair mechanisms in the south-east Asian Plasmodium falciparum parasites. These strategies may potentially emerge as the key players in warding off anti-malarial drug resistance in the near future. However, their implementation would be dictated by a host of factors like the epidemiological knowledge, population pharmacokinetics, drug-resistance patterns, cost, availability, and ease of adherence.

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Is Plasmodium Falciparum Resistance to Chloroquine Reversible in Absence of Drug Pressure?

Cited by 9 publications

References 3 publications

Surveillance of antimalarial drug resistance in China in the 1980s–1990s

Surveillance of antimalarial drug resistance in China in the 1980s–1990s

Plasmodium falciparum Infection and the Other Human Malarias

Triple Combination Therapy and Drug Cycling—Tangential Strategies for Countering Artemisinin Resistance

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