In vitro drug sensitivity of Plasmodium falciparum in Acre, Brazil

The state of Acre in western Brazil is representative of the South American Amazon jungle in geography, population change and an increase in malaria transmission. Malaria control in the rural areas is primarily dependent on visits of Ministry of Health personnel, who limit their efforts to the application of residual insecticides and the use of amodiaquine for treatment. Chloroquine, mefloquine, amodiaquine and quinine are among the drugs that are usually effective in the treatment of malaria. These drugs, as well as the combination of sulfadoxine-pyrimethamine, were studied in drug sensitivity tests to measure their effectiveness against Plasmodium falciparum, an organism responsible for malaria, in this area. The results of this study indicate that these drugs appear to have largely lost their efficacy against this organism, although quinine remains an effective therapy. Appropriate and compliant use is not readily achieved because of the side effects, and suitable partner compounds that would make quinine use more palatable are not readily available. Other suitable therapeutic regimens require the kind of services and follow-up not readily in available in this geographic setting. (Consumer Summary produced by Reliance Medical Information, Inc.)