Resistance to Chloroquine by Plasmodium vivax in Irian Jaya, Indonesia

Baird, J. Kevin; Basri, Hasan; Purnomo, Purnomo; Bangs, Michael J.; Subianto, Budi; Patchen, Leslie C.; Hoffman, S. L.

doi:10.4269/ajtmh.1991.44.547

Cited by 200 publications

(135 citation statements)

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“…It is still the drug of choice for nearly all Plasmodium vivax, P. malariae, and P. ovale malaria, and it is still used extensively to treat falciparum malaria despite widespread resistance. Resistance in P. falciparum developed independently in South-East Asia and South America in the late 1950s, and was ¢rst reported in P. vivax ten years ago in Papua New Guinea (Baird et al 1991;White 1992a;Rieckmann et al 1989). In western Cambodia (one of the two original foci), resistance ¢rst to pyrimethamine, and then to chloroquine may have resulted from the general distribution of sea salt impregnated with the drugs as a malaria control measure.…”

Section: Drug Resistance (A) Chloroquine Resistancementioning

confidence: 99%

Antimalarial drug resistance and combination chemotherapy

White

1999

Phil. Trans. R. Soc. Lond. B

506

467

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Antimarial drug resistance develops when spontaneously occurring parasite mutants with reduced susceptibility are selected, and are then transmitted. Drugs for which a single point mutation confers a marked reduction in susceptibility are particularly vulnerable. Low clearance and a shallow concentration^e¡ect relationship increase the chance of selection. Use of combinations of antimalarials that do not share the same resistance mechanisms will reduce the chance of selection because the chance of a resistant mutant surviving is the product of the per parasite mutation rates for the individual drugs, multiplied by the number of parasites in an infection that are exposed to the drugs. Artemisinin derivatives are particularly e¡ective combination partners because (i) they are very active antimalarials, producing up to 10 000-fold reductions in parasite biomass per asexual cycle; (ii) they reduce malaria transmissibility; and (iii) no resistance to these drugs has been reported yet. There are good arguments for no longer using antimalarial drugs alone in treatment, and instead always using a combination with artemisinin or one of its derivatives.

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Section: Drug Resistance (A) Chloroquine Resistancementioning

confidence: 99%

Antimalarial drug resistance and combination chemotherapy

White

1999

Phil. Trans. R. Soc. Lond. B

506

467

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“…1 CQR P. vivax. The first reports of CQR P. vivax were published in 1989 from Australian travelers to Papua New Guinea, 65 and in 1991 as an endemic problem in Indonesia, 66 30 years after the documentation of CQR P. falciparum. Although intrinsic differences in the transmission dynamics between these two species may account for much of the time lag, it is likely that this also reflects the inherent complexity of defining antimalarial treatment efficacy of P. vivax.…”

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confidence: 99%

Diagnosis and Treatment of Plasmodium vivax Malaria

Baird

Maguire

Price

2012

Advances in Parasitology

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“…Resistance to chloroquine, once the drug of choice for the prevention and treatment of all malarias, is common in nearly all areas where P. falciparum is transmitted (39,55). Also of concern is the emergence in the last 3 years of chloroquine-resistant P. vivax in Indonesia and New Guinea (2,62,79,102). Resistance to mefloquine, a more recently developed and very promising drug, has already been reported in many parts of the world and approaches 50% in some parts of Thailand (95).…”

Section: The Malaria Problemmentioning

confidence: 99%

Malaria vaccine development

Jones

Hoffman

1994

Clin Microbiol Rev

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The malaria parasite life cycle presents several targets for attack, but these different parts of the life cycle are susceptible to different types of host immune response. For example, the sporozoite is most sensitive to immune antibody, while liver stage parasites can be eliminated by cytotoxic T lymphocytes. Attachment of merozoites to erythrocytes, on the other hand, can be blocked by antibody. Convincing experimental evidence shows that completely protective immunity to malaria can be induced. The challenge now is to design recombinant or synthetic vaccines that induce the right types of immune responses to specific life cycle stages. This requires the identification and characterization of B- and T-lymphocyte epitopes expressed by the parasite or by parasitized host cells. These epitopes must be incorporated into a delivery system that maximizes the interaction between the vaccine epitopes and the host immune system. Many epitopes from several parts of the life cycle are already characterized; development of multivalent vaccines, that is, vaccines which contain immunogens from more than one part of the life cycle, is a promising area for research efforts.

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Resistance to Chloroquine by Plasmodium vivax in Irian Jaya, Indonesia

Cited by 200 publications

References 0 publications

Antimalarial drug resistance and combination chemotherapy

Antimalarial drug resistance and combination chemotherapy

Diagnosis and Treatment of Plasmodium vivax Malaria

Malaria vaccine development

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