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Chloroquine- and sulfadoxine-pyrimethamine-resistant falciparum malaria in vivo– a pilot study in rural Zambia

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background  Chloroquine (CQ) and Sulfadoxine-Pyrimethamine (SP) are the predominantly used antimalarials in Zambia and other parts of East Africa, but increasing resistance of P. falciparum is a major concern.

methods  Seventy consecutive patients with uncomplicated falciparum malaria were enrolled. In 43 patients, no prior CQ use could be demonstrated by history and urianalysis (qualitative test, Dill & Glazko) and these patients were given CQ; the other 27 had taken CQ before and received SP.

results  Combined R-II and R-III CQ-resistance was 58% (60% in under-fives), which is the range previously reported from Zambia. By contrast, SP-resistance (R-II and R-III) was much higher (26%) than previously reported (3% – 17%). The history of prior CQ intake correlated well with the results of the Dill–Glazko test; there was no evidence for prior SP intake to explain these results.

conclusion  If our findings of SP resistance are confirmed, other drugs such as quinine, atovaquone/proguanil and artemisinin are required to treat malaria in Zambia.
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Keywords: Zambia; chloroquine; in vivo sensitivity; malaria; sulfadoxine/pyrimethamine

Document Type: Research Article

Affiliations: 1: Kaoma District Hospital, Kaoma, Zambia 2: Department of Internal Medicine, Groningen University Hospital, The Netherlands

Publication date: 01 October 2000

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