1. Application of a multi-faceted approach for the assessment of treatment response in falciparum malaria: a study from Malaysian Borneo.
- Author
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Cox-Singh J, Lu HY, Davis TM, Ilett KF, Hackett LP, Matusop A, and Singh B
- Subjects
- Animals, Borneo, Chloroquine therapeutic use, Drug Resistance, Multiple, Genes, MDR, Genes, Protozoan, Genetic Markers, Humans, Plasmodium falciparum genetics, Point Mutation, Pyrimethamine therapeutic use, Sulfadoxine therapeutic use, Treatment Outcome, Antimalarials therapeutic use, Malaria, Falciparum drug therapy
- Abstract
Thirty-two patients reporting to the Lundu District Hospital, Sarawak, Malaysian Borneo, with uncomplicated falciparum malaria were recruited into a multifaceted study to assess treatment response. Following combined chloroquine and sulphadoxine/pyrimethamine treatment the patients were followed for 28 days according to the World Health Organisation in vivo drug response protocol. The in vivo study revealed that 13 (41%) of the patients had a sensitive response to treatment, five (16%) cleared asexual stage parasites but had persistent gametocytes, 11 (34%) had RI type resistance and three (9%) had RII type resistance requiring quinine intervention before day 7 for parasite clearance. Although clinically insignificant, patients with persistent gametocytes, surviving chloroquine and sulphadoxine/pyrimethamine treatment during maturation, were placed in the reduced response to treatment group for analysis. Allelic typing detected 100% prevalence of the pfcrt K76T marker associated with chloroquine resistance and 78% prevalence of the pfdhfr NRNL haplotype associated with sulphadoxine/pyrimethamine treatment failure. High serum chloroquine levels and pfdhfr haplotypes with
- Published
- 2003
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