Displaying publications 1 - 20 of 143 in total

Abstract:
Sort:
  1. [Monkey malaria in a traveller from Malaysia]
    van Hellemond JJ, van Genderen PJ
    Ned Tijdschr Geneeskd, 2010;154:A1353.
    PMID: 20456798
    Matched MeSH terms: Chloroquine/therapeutic use
  2. Fulltext Imported malaria: a retrospective study in University Hospital, Kuala Lumpur, a ten-year experience
    Jamaiah I, Anuar AK, Najib NA, Zurainee MN
    Med J Malaysia, 1998 Mar;53(1):6-9.
    PMID: 10968130
    Over a period of ten years (1983-1992), 134 malaria cases admitted to University Hospital, Kuala Lumpur (UHKL) were analysed. Malays constituted 27.6%, Chinese 29.8%, Indians 9.7%, Indonesians 16.4% and other foreigners 16.4%. Therefore, of the total number of cases, foreigners constituted 32.8% (44) of all the malaria cases admitted to UHKL. Fifteen of these foreigners had chloroquine-resistant strains of malarial parasites. Three species of malaria were reported of which Plasmodium falciparum constituted the most (46.3%) (80% of these developed resistance to chloroquine). Plasmodium vivax was confirmed in 44.8% (10% of these developed resistance to chloroquine) and there was only one case of Plasmodium malarie infection.
    Matched MeSH terms: Chloroquine/therapeutic use
  3. Fulltext Antimalarial properties of Goniothalamin in combination with chloroquine against Plasmodium yoelii and Plasmodium berghei growth in mice
    Mohd Ridzuan MA, Ruenruetai U, Noor Rain A, Khozirah S, Zakiah I
    Trop Biomed, 2006 Dec;23(2):140-6.
    PMID: 17322815 MyJurnal
    Malaria is a disease which is still endemic and has become a disastrous scourge because of the emergence of antimalarial drug resistant Plasmodium falciparum. A new approach in addressing this is in developing a combination drug. This study is to show the enhancement of antimalarial properties, when single compound, goniothalamin combine with standard drug, chloroquine. Based on 4 Day Test, percentage of parasite growth on treated infected mice were determined. Oral treatment with 1 mg/kg BW of chloroquine on experimental mice suppressed 70% and 76.7% of both Plasmodium yoelii and Plasmodium berghei, respectively. The infection of P. berghei in mice was inhibited less than 50% by goniothalamin individual treatment at all doses in this study. About 27.8% and 18.5% inhibition of infection were observed in P. yoelii infected mice treated with 30 mg/kg and 60 mg/kg of goniothalamin respectively and the suppression exceed more than 50% at higher doses (90 and 120 mg/kg). Combination of 1 mg/kg chloroquine with either 30 mg/kg or 60 mg/kg of goniothalamin decreased the parasitemia of P. yoelii infected mice more than 90% and prolong the survival up to 100% after treatment. Similar treatment to P. berghei infected mice only shows about 60% reduction of parasitemia. The study findings showed that antimalarial property of goniothalamin was enhanced by combination with chloroquine at lower dose of each drug.
    Matched MeSH terms: Chloroquine/administration & dosage; Chloroquine/pharmacology*
  4. Fulltext Artesunate-mefloquine versus chloroquine for treatment of uncomplicated Plasmodium knowlesi malaria in Malaysia (ACT KNOW): an open-label, randomised controlled trial
    Grigg MJ, William T, Menon J, Dhanaraj P, Barber BE, Wilkes CS, et al.
    Lancet Infect Dis, 2016 Feb;16(2):180-188.
    PMID: 26603174 DOI: 10.1016/S1473-3099(15)00415-6
    BACKGROUND: The zoonotic parasite Plasmodium knowlesi has become the most common cause of human malaria in Malaysia and is present throughout much of southeast Asia. No randomised controlled trials have been done to identify the optimum treatment for this emerging infection. We aimed to compare artesunate-mefloquine with chloroquine to define the optimum treatment for uncomplicated P knowlesi malaria in adults and children.

    METHODS: We did this open-label, randomised controlled trial at three district hospitals in Sabah, Malaysia. Patients aged 1 year or older with uncomplicated P knowlesi malaria were randomly assigned, via computer-generated block randomisation (block sizes of 20), to receive oral artesunate-mefloquine (target dose 12 mg/kg artesunate and 25 mg/kg mefloquine) or chloroquine (target dose 25 mg/kg). Research nursing staff were aware of group allocation, but allocation was concealed from the microscopists responsible for determination of the primary endpoint, and study participants were not aware of drug allocation. The primary endpoint was parasite clearance at 24 h. Analysis was by modified intention to treat. This study is registered with ClinicalTrials.gov, number NCT01708876.

    FINDINGS: Between Oct 16, 2012, and Dec 13, 2014, we randomly assigned 252 patients to receive either artesunate-mefloquine (n=127) or chloroquine (n=125); 226 (90%) patients comprised the modified intention-to-treat population. 24 h after treatment, we recorded parasite clearance in 97 (84% [95% CI 76-91]) of 115 patients in the artesunate-mefloquine group versus 61 (55% [45-64]) of 111 patients in the chloroquine group (difference in proportion 29% [95% CI 18·0-40·8]; p<0·0001). Parasite clearance was faster in patients given artesunate-mefloquine than in those given chloroquine (18·0 h [range 6·0-48·0] vs 24·0 h [6·0-60·0]; p<0·0001), with faster clearance of ring stages in the artesunate-mefloquine group (mean time to 50% clearance of baseline parasites 8·6 h [95% CI 7·9-9·4] vs 13·8 h [12·1-15·4]; p<0·0001). Risk of anaemia within 28 days was lower in patients in the artesunate-mefloquine group (71 [62%; 95% CI 52·2-70·6]) than in those in the chloroquine group (83 [75%; 65·6-82·5]; p=0·035). Gametocytaemia as detected by PCR for pks25 was present in 44 (86%) of 51 patients in the artesunate-mefloquine group and 41 (84%) of 49 patients in the chloroquine group at baseline, and in three (6%) of 49 patients and two (4%) of 48 patients, respectively, at day 7. Fever clearance was faster in the artesunate-mefloquine group (mean 11·5 h [95% CI 8·3-14·6]) than in the chloroquine group (14·8 h [11·7-17·8]; p=0·034). Bed occupancy was 2426 days per 1000 patients in the artesunate-mefloquine group versus 2828 days per 1000 patients in the chloroquine group (incidence rate ratio 0·858 [95% CI 0·812-0·906]; p<0·0001). One (<1%) patient in the artesunate-mefloquine group had a serious neuropsychiatric event regarded as probably related to study drug.

    INTERPRETATION: Artesunate-mefloquine is highly efficacious for treatment of uncomplicated P knowlesi malaria. The rapid therapeutic response of the drug offers significant advantages compared with chloroquine monotherapy and supports a unified treatment policy for artemisinin-based combination therapy for all Plasmodium species in co-endemic areas.

    FUNDING: Malaysian Ministry of Health, Australian National Health and Medical Research Council, and Asia Pacific Malaria Elimination Network.

    Matched MeSH terms: Chloroquine/therapeutic use*
  5. Fulltext A study protocol for a randomised open-label clinical trial of artesunate-mefloquine versus chloroquine in patients with non-severe Plasmodium knowlesi malaria in Sabah, Malaysia (ACT KNOW trial)
    Grigg MJ, William T, Dhanaraj P, Menon J, Barber BE, von Seidlein L, et al.
    BMJ Open, 2014 Aug 19;4(8):e006005.
    PMID: 25138814 DOI: 10.1136/bmjopen-2014-006005
    INTRODUCTION: Malaria due to Plasmodium knowlesi is reported throughout South-East Asia, and is the commonest cause of it in Malaysia. P. knowlesi replicates every 24 h and can cause severe disease and death. Current 2010 WHO Malaria Treatment Guidelines have no recommendations for the optimal treatment of non-severe knowlesi malaria. Artemisinin-combination therapies (ACT) and chloroquine have each been successfully used to treat knowlesi malaria; however, the rapidity of parasite clearance has not been prospectively compared. Malaysia's national policy for malaria pre-elimination involves mandatory hospital admission for confirmed malaria cases with discharge only after two negative blood films; use of a more rapidly acting antimalarial agent would have health cost benefits. P. knowlesi is commonly microscopically misreported as P. malariae, P. falciparum or P. vivax, with a high proportion of the latter two species being chloroquine-resistant in Malaysia. A unified ACT-treatment protocol would provide effective blood stage malaria treatment for all Plasmodium species.

    METHODS AND ANALYSIS: ACT KNOW, the first randomised controlled trial ever performed in knowlesi malaria, is a two-arm open-label trial with enrolments over a 2-year period at three district sites in Sabah, powered to show a difference in proportion of patients negative for malaria by microscopy at 24 h between treatment arms (clinicaltrials.gov #NCT01708876). Enrolments started in December 2012, with completion expected by September 2014. A total sample size of 228 is required to give 90% power (α 0.05) to determine the primary end point using intention-to-treat analysis. Secondary end points include parasite clearance time, rates of recurrent infection/treatment failure to day 42, gametocyte carriage throughout follow-up and rates of anaemia at day 28, as determined by survival analysis.

    ETHICS AND DISSEMINATION: This study has been approved by relevant institutional ethics committees in Malaysia and Australia. Results will be disseminated to inform knowlesi malaria treatment policy in this region through peer-reviewed publications and academic presentations.

    TRIAL REGISTRATION NUMBER: NCT01708876.

    Matched MeSH terms: Chloroquine/therapeutic use*
  6. Fulltext Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia
    William T, Menon J, Rajahram G, Chan L, Ma G, Donaldson S, et al.
    Emerg Infect Dis, 2011 Jul;17(7):1248-55.
    PMID: 21762579 DOI: 10.3201/eid1707.101017
    The simian parasite Plasmodium knowlesi causes severe human malaria; the optimal treatment remains unknown. We describe the clinical features, disease spectrum, and response to antimalarial chemotherapy, including artemether-lumefantrine and artesunate, in patients with P. knowlesi malaria diagnosed by PCR during December 2007-November 2009 at a tertiary care hospital in Sabah, Malaysia. Fifty-six patients had PCR-confirmed P. knowlesi monoinfection and clinical records available for review. Twenty-two (39%) had severe malaria; of these, 6 (27%) died. Thirteen (59%) had respiratory distress; 12 (55%), acute renal failure; and 12, shock. None experienced coma. Patients with uncomplicated disease received chloroquine, quinine, or artemether-lumefantrine, and those with severe disease received intravenous quinine or artesunate. Parasite clearance times were 1-2 days shorter with either artemether-lumefantrine or artesunate treatment. P. knowlesi is a major cause of severe and fatal malaria in Sabah. Artemisinin derivatives rapidly clear parasitemia and are efficacious in treating uncomplicated and severe knowlesi malaria.
    Matched MeSH terms: Chloroquine/administration & dosage; Chloroquine/therapeutic use
  7. Lansium domesticum: skin and leaf extracts of this fruit tree interrupt the lifecycle of Plasmodium falciparum, and are active towards a chloroquine-resistant strain of the parasite (T9) in vitro
    Yapp DT, Yap SY
    J Ethnopharmacol, 2003 Mar;85(1):145-50.
    PMID: 12576213
    Malaria remains a global problem in the light of chloroquine-resistant strains of Plasmodium falciparum. New compounds are needed for the development of novel antimalarial drugs. Seed, leaf, and fruit skin extracts of Lansium domesticum, a common fruit tree in South-East Asia, are used by indigenous tribes in Sabah, Malaysia for treating malaria. The skin and aqueous leaf extracts of the tree were found to reduce parasite populations of the drug sensitive strain (3D7) and the chloroquine-resistant strain (T9) of P. falciparum equally well. The skin extracts were also found to interrupt the lifecycle of the parasite. The data reported here indicate that extracts of L. domesticum are a potential source for compounds with activity towards chloroquine-resistant strains of P. falciparum.
    Matched MeSH terms: Chloroquine/pharmacology
  8. Fulltext Chloroquine-resistant malaria in West Malaysia
    McKelvey TP, Lundie AR, Williams ED, Moore HS, Worsley DE
    Br Med J, 1968 Dec 14;4(5632):703-4.
    PMID: 5723393
    Matched MeSH terms: Chloroquine/therapeutic use*
  9. Nephropathy in Malaria
    Wolthuis FH
    Trop Geogr Med, 1968 Mar;20(1):21-7.
    PMID: 4868143
    Matched MeSH terms: Chloroquine/therapeutic use
  10. Studies on the chemotherapy of malaria. I. The suppression of malaria by synthetic drugs
    Field JW, Strahan JH, Edeson JF, Wilson T
    Med J Malaya, 1954;7:67-89.
    This paper from the Malaria Research Division, Institute for Medical Research, Federation of Malaya, summarizes the results of studies on the suppression of malaria by synthetic drugs. Such studies began 25 years ago, and, in spite of interruptions in the work due to the Japanese invasion and due to banditry, studies are reported here on the effects of giving mepacrine in doses of 0.3 gm. once a week; proguanil in doses of 0.1 gm., 0.2 gm., 0.25 gm. and 0.3 gm. once a week; chloroquine in doses of 0.25 gm. once a week; and amodiaquin [camoquin] in dosos of 0.4 grn. base once a month. The populations upon whom the studies were made were labourers and their families-Tamils, Malays, and Javanese, on 3 estates in Selangor, and Negri Sembilan, Federation of Malaya, between December, 1946, and February, 1949. Each population was divided into 3 comparable sections, 2 of which received test drugs, while the third received a placebo and so formed a control group. Drugs were issued under the supervision of a Malaria Research Officer. Those people who developed fever wore supervised and treated by a hospital assistant resident on each estate. Thick blood films from such patients were studied. Parasite and spleen surveys were done every 3 months. Malaria transmission was assessed by the incidence of malaria in unprotected infants, who were not given suppressive drugs until after their first attack; and by the results of mosquito dissections. The commonest vectors woreA. letifer, A. maoulatus and A. umbrosus. The results of the tests of suppressivo drugs are shown in a series of tables, charts, and diagrams. Malarial transmission was considered light during the period of these trials. Chloroquino 0.25 gm. base once weekly proved the most effective drug in suppressing malarial attacks. There was little difference between proguanil in various doses, or between proguanil and mepacrine, but these two drugs were much cheaper than chloroquine or amodiaquin. All the drugs reduced the parasite and spleen rates. No significant toxic symptoms were observed with any of the drugs used. S. Bell.
    Matched MeSH terms: Chloroquine
  11. Fulltext Influence of the pfmdr1 Gene on In Vitro Sensitivities of Piperaquine in Thai Isolates of Plasmodium falciparum
    Mungthin M, Watanatanasup E, Sitthichot N, Suwandittakul N, Khositnithikul R, Ward SA
    Am J Trop Med Hyg, 2017 03;96(3):624-629.
    PMID: 28044042 DOI: 10.4269/ajtmh.16-0668
    Piperaquine combined with dihydroartemisinin is one of the artemisinin derivative combination therapies, which can replace artesunate-mefloquine in treating uncomplicated falciparum malaria in Thailand. The aim of this study was to determine the in vitro sensitivity of Thai Plasmodium falciparum isolates against piperaquine and the influence of the pfmdr1 gene on in vitro response. One hundred and thirty-seven standard laboratory and adapted Thai isolates of P. falciparum were assessed for in vitro piperaquine sensitivity. Polymorphisms of the pfmdr1 gene were determined by polymerase chain reaction methods. The mean and standard deviation of the piperaquine IC50 in Thai isolates of P. falciparum were 16.7 ± 6.3 nM. The parasites exhibiting chloroquine IC50 of ≥ 100 nM were significantly less sensitive to piperaquine compared with the parasite with chloroquine IC50 of < 100 nM. No significant association between the pfmdr1 copy number and piperaquine IC50 values was found. In contrast, the parasites containing the pfmdr1 86Y allele exhibited significantly reduced piperaquine sensitivity. Before nationwide implementation of dihydroartemisinin-piperaquine as the first-line treatment in Thailand, in vitro and in vivo evaluations of this combination should be performed especially in areas where parasites containing the pfmdr1 86Y allele are predominant such as the Thai-Malaysian border.
    Matched MeSH terms: Chloroquine/pharmacology
  12. Intraspecific variation in Plasmodium falciparum
    Aikawa M, Ward RA
    Am J Trop Med Hyg, 1974 Jul;23(4):570-3.
    PMID: 4367833
    Matched MeSH terms: Chloroquine/pharmacology
  13. Mass suppression with chloroquine: chloroquine and pentaquine, and neo-premaline
    Wallace RB
    Med J Malaya, 1950;4:190-204.
    This work, carried out on a rubber estate in Malaya during 1949, was a Continuation of the trials begun in 1948 previously recorded [this Bulletin, 1949, v 46, 1116]. Full details concerning the terrain and the nature of the experiment were given in the previous publication. In 1949 the malaria rate in the area approached the rates which were customary in pre-war years, for the first time since the reoccupation of the country. The Indian population which was chosen for the experiment contains the survivors of the Japanese occupation; many had been in Siam and almost all had suffered from malaria. Treatment had been entirely lacking or very inadequate, with the result that the survivors had developed a high degree of immunity by the end of the war. These facts probably explain the low incidence of malaria in post-war years in spite of high prevalence of A. maculatus. No anti-larval measures have been carried out since 1941. Neo-premaline completely suppressed malaria in one group, the control group showing a high incidence. In other groups chloroquine, or chloroquine and pentaquine combined, given once a week, promptly brought to an end primary waves of malaria which were rising rapidly.
    Matched MeSH terms: Chloroquine
  14. Efficacy and safety of chloroquine for treatment in patients with uncomplicated Plasmodium vivax infections in endemic countries
    Naing C, Aung K, Win DK, Wah MJ
    Trans R Soc Trop Med Hyg, 2010 Nov;104(11):695-705.
    PMID: 20850161 DOI: 10.1016/j.trstmh.2010.08.009
    Chloroquine (CQ) is a relatively inexpensive drug for treatment of malaria. If efficacy of CQ is still assumed, then it should be indicated in malaria treatment policies as the drug of choice for uncomplicated Plasmodium vivax malaria in endemic countries with resource constraints. The objective of this review is to summarize the existing evidence on the relative efficacy and safety of CQ in treating patients with uncomplicated P. vivax malaria in endemic countries. We searched online data bases (PUBMED, MEDLINE, EMBASE, The Cochrane Library) and the reference lists of the retrieved articles. Fifteen randomized controlled trials (n=6215) assessing the relative efficacy and safety of CQ for treatment of uncomplicated P. vivax malaria were included. CQ monotherapy was compared to CQ plus primaquine (PQ), artemisinin/artemether, artemisinin based combination therapy, quinine, CQ plus tafenoquine, chlorguanil plus dapsone, azithromycin, or placebo. Treatment efficacy was not significantly different between the CQ monotherapy group and that of the CQ with PQ 14 day group at 28 day follow-up (55/711, 7.7% vs 35/712, 4.9%; P=0.16). Evidence from the trials identified for this review draw a fairly clear conclusion about the relative efficacy and safety of CQ for treating uncomplicated P. vivax malaria infection. However, further research in this field with well powered, randomized, non-inferiority design, using the standardized protocol is needed.
    Matched MeSH terms: Chloroquine/therapeutic use*
  15. Resochin; single dose therapy and mass suppression
    WALLACE MF
    Med J Malaya, 1954 Mar;8(3):251-9.
    PMID: 13164695
    Matched MeSH terms: Chloroquine*
  16. Synthesis and biological evaluation of hydantoin derivatives as potent antiplasmodial agents
    Chin EZ, Chang WJ, Tan HY, Liew SY, Lau YL, Ng YL, et al.
    Bioorg Med Chem Lett, 2024 May 01;103:129701.
    PMID: 38484804 DOI: 10.1016/j.bmcl.2024.129701
    Malaria, a devastating disease, has claimed numerous lives and caused considerable suffering, with young children and pregnant women being the most severely affected group. However, the emergence of multidrug-resistant strains of Plasmodium and the adverse side effects associated with existing antimalarial drugs underscore the urgent need for the development of novel, well-tolerated, and more efficient drugs to combat this global health threat. To address these challenges, six new hydantoins derivatives were synthesized and evaluated for their in vitro antiplasmodial activity. Notably, compound 2c exhibited excellent inhibitory activity against the tested Pf3D7 strain, with an IC50 value of 3.97 ± 0.01 nM, three-fold better than chloroquine. Following closely, compound 3b demonstrated an IC50 value of 27.52 ± 3.37 µM against the Pf3D7 strain in vitro. Additionally, all the hydantoins derivatives tested showed inactive against human MCR-5 cells, with an IC50 value exceeding 100 μM. In summary, the hydantoin derivative 2c emerges as a promising candidate for further exploration as an antiplasmodial compound.
    Matched MeSH terms: Chloroquine/pharmacology
  17. Fulltext Prevalence of Plasmodium falciparum Molecular Markers of Antimalarial Drug Resistance in a Residual Malaria Focus Area in Sabah, Malaysia
    Norahmad NA, Mohd Abd Razak MR, Abdullah NR, Sastu UR, Imwong M, Muniandy PK, et al.
    PLoS One, 2016;11(10):e0165515.
    PMID: 27788228 DOI: 10.1371/journal.pone.0165515
    Chloroquine (CQ) and fansidar (sulphadoxine-pyrimethamine, SP) were widely used for treatment of Plasmodium falciparum for several decades in Malaysia prior to the introduction of Artemisinin-based Combination Therapy (ACT) in 2008. Our previous study in Kalabakan, located in south-east coast of Sabah showed a high prevalence of resistance to CQ and SP, suggesting the use of the treatment may no longer be effective in the area. This study aimed to provide a baseline data of antimalarial drug resistant markers on P. falciparum isolates in Kota Marudu located in the north-east coast of Sabah. Mutations on genes associated with CQ (pfcrt and pfmdr1) and SP (pfdhps and pfdhfr) were assessed by PCR amplification and restriction fragment length polymorphism. Mutations on the kelch13 marker (K13) associated with artemisinin resistance were determined by DNA sequencing technique. The assessment of pfmdr1 copy number variation associated with mefloquine resistant was done by real-time PCR technique. A low prevalence (6.9%) was indicated for both pfcrt K76T and pfmdr1 N86Y mutations. All P. falciparum isolates harboured the pfdhps A437G mutation. Prevalence of pfdhfr gene mutations, S108N and I164L, were 100% and 10.3%, respectively. Combining the different resistant markers, only two isolates were conferred to have CQ and SP treatment failure markers as they contained mutant alleles of pfcrt and pfmdr1 together with quintuple pfdhps/pfdhfr mutation (combination of pfdhps A437G+A581G and pfdhfr C59R+S108N+I164L). All P. falciparum isolates carried single copy number of pfmdr1 and wild type K13 marker. This study has demonstrated a low prevalence of CQ and SP resistance alleles in the study area. Continuous monitoring of antimalarial drug efficacy is warranted and the findings provide information for policy makers in ensuring a proper malaria control.
    Matched MeSH terms: Chloroquine/pharmacology; Chloroquine/therapeutic use
  18. Fulltext The detection of pfcrt and pfmdr1 point mutations as molecular markers of chloroquine drug resistance, Pahang, Malaysia
    Atroosh WM, Al-Mekhlafi HM, Mahdy MA, Surin J
    Malar J, 2012;11:251.
    PMID: 22853645 DOI: 10.1186/1475-2875-11-251
    Malaria is still a public health problem in Malaysia with chloroquine (CQ) being the first-line drug in the treatment policy of uncomplicated malaria. There is a scarcity in information about the magnitude of Plasmodium falciparum CQ resistance. This study aims to investigate the presence of single point mutations in the P. falciparum chloroquine-resistance transporter gene (pfcrt) at codons 76, 271, 326, 356 and 371 and in P. falciparum multi-drug resistance-1 gene (pfmdr1) at codons 86 and 1246, as molecular markers of CQ resistance.
    Matched MeSH terms: Chloroquine/pharmacology*
  19. Different patterns of pfcrt and pfmdr1 polymorphism in Plasmodium falciparum isolates from Tehama region, Yemen
    Atroosh WM, Al-Mekhlafi HM, Al-Jasari A, Sady H, Dawaki SS, Elyana FN, et al.
    PeerJ, 2016;4:e2191.
    PMID: 27478699 DOI: 10.7717/peerj.2191
    Introduction. Despite the efforts of the malaria control programme, malaria morbidity is still a common health problem in Yemen, with 60% of the population at risk. Plasmodium falciparum is responsible for 99% of malaria cases. The emergence in Yemen of parasite resistance to chloroquine (CQ) prompted the adoption of artemisinin combination therapy (ACT) in 2009, which involves the use of artesunate plus sulphadoxine-pyrimethamine (AS + SP). However, CQ was retained as the drug of choice for vivax malaria. To assess the impact of the change in the malaria treatment policy five years after its introduction, the present study investigated the mutations in the CQ resistance transporter (pfcrt) and multidrug resistance 1 (pfmdr1) genes. Method. A molecular investigation of 10 codons of pfcrt (72-76, 220, 271, 326, 356, and 371) and five codons of pfmdr1 (86, 184, 1034, 1042, and 1246) was conducted on P. falciparum isolates from districts with the highest malaria endemicity in the Hodeidah and Al-Mahwit governorates in Tehama region, Yemen. A total of 86 positive cases of falciparum monoinfection were investigated for the presence of mutations related to CQ and other antimalarials using a PCR-RFLP assay. Results. There was a wide prevalence of pfcrt gene mutations with the pfcrt 76T CQ resistance marker being predominant (97.7%). The prevalence of other pfcrt mutations varied from high (75E: 88%) to moderate (74I: 79.1%, 220S: 69.8%, 271E and 371I: 53.5%) or low (326S: 36%, 72S: 10.5%). Mutated pfcrt 72-76 amino acids haplotypes were highly prevalent (98.8%). Among these, the CVIET classic, old-world African/Southeast Asian haplotype was the most predominant, and was mostly found in the isolates from the Khamis Bani Saad district of Al-Mahwit (93.1%) and the AdDahi district of Hodeidah (88.9%). However, it was only found in 26.3% of the isolates from the Bajil district of Hodeidah. Surprisingly, the SVMNT new-world South American haplotype was exclusively detected in 9.3% of the isolates from the Bajil district of Hodeidah. Mutations at Y184F of pfmdr1 were found in all isolates (100%) from all districts. The mutation for codons 1034C and 86Y were found only in the isolates from the AdDahi and Khamis Bani Saad districts. Overall, the AdDahi and Khamis Bani Saad districts were similar in terms of carrying most of the mutations in the pfcrt and pfmdr1 genes, while there was a lower prevalence of mutation in the isolates from the Bajil district. Conclusion. The high prevalence of mutations in pfcrt 5 years after the official cessation of CQ use against P. falciparum suggests that there is sustained CQ pressure on P. falciparum isolates in the study area. Moreover, the low prevalence of mutations in the pfmdr1 gene could be a good indicator of the high susceptibility of P. falciparum isolates to antimalarials other than CQ. A new strategy to ensure the complete nationwide withdrawal of CQ from the private drug market is recommended.
    Matched MeSH terms: Chloroquine
  20. Plasmodium hylobati: a malaria parasite of the gibbon
    Collins WE, Contacos PG, Garnham PC, Warren M, Skinner JC
    J Parasitol, 1972 Feb;58(1):123-8.
    PMID: 4335047
    Matched MeSH terms: Chloroquine/therapeutic use
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links