AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 69(5), 2003, pp. 555-557
Copyright © 2003 by The American Society of Tropical Medicine and Hygiene

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MULTI-DRUG RESISTANT PLASMODIUM FALCIPARUM MALARIA IN ASSAM, INDIA: TIMING OF RECURRENCE AND ANTI-MALARIAL DRUG CONCENTRATIONS IN WHOLE BLOOD

VIRENDRA K. DUA, VAS DEV, S. PHOOKAN, N. C. GUPTA, V. P. SHARMA, AND S. K. SUBBARAO
Malaria Research Centre, Field Station, Sector III, Ranipur, Hardwar, India; Malaria Research Centre, Field Station, Sonapur, Kamrup, Assam, India; Malaria Research Centre, Delhi, India

The susceptibility of 23 cases of Plasmodium falciparum malaria from the Sonapur primary health center in the Kamrup district of Assam, India to different antimalarials was investigated using the 28-day World Health Organization in vivo test. Whole blood concentrations of chloroquine, sulfadoxine, and quinine were determined at different intervals and at the time of parasites recrudescence after completion of treatment with the respective drugs to confirm the status of drug sensitivity. A case of multi-drug resistant P. falciparum malaria was found where recrudescence occurred, despite standard oral treatment with chloroquine, sulfadoxine/pyrimethamine, and quinine sequentially. Whole blood concentrations of chloroquine, sulfadoxine, and quinine at the time of recrudescence were 0.35 µg/ml (day 7), 18 µg/ml (day 14), and 0.009 µg/ml (day 14), respectively. Therefore, monitoring of drug-resistant P. falciparum malaria and its proper treatment should be intensified to check the spread of multi-drug resistant strains in other parts of the country.

Received November 19, 2002. Accepted for publication May 22, 2003.

Acknowledgments: We are thankful to Dr. B. Das (Primary Health Center, Sonapur) for overall clinical supervision and appropriate treatment of malaria cases. Thanks are also due to Dr. G. Edwards (Department of Pharmacology University of Liverpool, Liverpool, United Kingdom) for critical comments on the manuscript.

Authors’ addresses: Virendra K. Dua and N. C. Gupta, Malaria Research Centre, Field Station, Sector III, BHEL, Ranipur, Hardwar 249 403, India, E-mail: virendradua{at}hotmail.com. Vas Dev and S. Phookan, Malaria Research Centre, Field Station, Sonapur, Kamrup, Assam 782 402, India. V. P. Sharma and S. K. Subbarao, Malaria Research Centre, 22 Sham Nath Marg, Delhi 110 054, India.




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V. DEV, S. PHOOKAN, V. P. SHARMA, and S. P. ANAND
PHYSIOGRAPHIC AND ENTOMOLOGIC RISK FACTORS OF MALARIA IN ASSAM, INDIA
Am J Trop Med Hyg, October 1, 2004; 71(4): 451 - 456.
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