Volume 69, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The susceptibility of 23 cases of 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 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 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 malaria and its proper treatment should be intensified to check the spread of multi-drug resistant strains in other parts of the country.


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  1. Kondrashin AV, 1992. Malaria in the WHO Southeast Asia region. Indian J Malariol 29 : 129–160.
    [Google Scholar]
  2. Sehgal PN, Sharma MID, Sharma SI, Gogal S, 1973. Resistance to chloroquine in falciparum malaria in Assam state, India. J Commun Dis 5 : 175–180.
    [Google Scholar]
  3. Lal S, Dhillon GPS, Sonal GS, Sita Rama Rao B, 1998. Country Scenario – Malaria and Its Control in India. National Malaria Eradication Programme (Enhanced Malaria Control Project). Delhi: Ministry of Health and Family Welfare, Government of India publication.
  4. Dev V, Hira CR, Rajkhowa, 2001. Malaria-attributable morbidity in Assam, North-Eastern India. Ann Trop Med Parasitol 95 : 789–796.
    [Google Scholar]
  5. Alvan G, Ekman L, Lindstrom B, 1982. Determination of chloroquine and its desethyl metabolite in plasma, red blood cells and urine by liquid chromatography. J Chromatogr 229 : 241–247.
    [Google Scholar]
  6. Dua VK, Brohult J, Ericsson O, Sharma VP, 1986. High performance liquid chromatographic determination of chloroquine in finger-tip blood dried on filter paper: sample handling problems. Indian J Malariol 23 : 151–154.
    [Google Scholar]
  7. Dua VK, Sarin R, Sharma VP, 1994. Sulfadoxine concentrations in plasma, red blood cells and whole blood in healthy and Plasmodium falciparum malaria cases after treatment with Fansidar using high performance liquid chromatography. J Pharm Biomed Anal 12 : 1323–1328.
    [Google Scholar]
  8. Dua VK, Sarin R, Prakash A, 1993. Determination of quinine in serum, plasma, red blood cells and whole blood in healthy and Plasmodium falciparum malaria cases by high-performance liquid chromatography. J Chromatogr 614 : 87–93.
    [Google Scholar]
  9. Desjardins RE, Doberstyn EB, Wernsdorfer WH, 1988. The treatment and prophylaxis of malaria. Wernsdorfer WH, McGregor SI, eds. Malaria: Principles and Practice of Malariology. Volume I. New York: Churchill Livingstone, 827–864.
  10. Hellgren U, Kihamia CM, Mahikwano LF, Bjorkman A, Eriksson O, Rombo L, 1989. Response of Plasmodium falciparum to chloroquine treatment: relation to whole blood concentrations of chloroquine and desethylchloroquine. Bull World Health Organ 67 : 197–202.
    [Google Scholar]
  11. Na-Bangchang K, Karbwang J, 1993. Clinical pharmacology of chloroquine. Karbwang J, Wernsdorfer WH, eds. Clinical Pharmacology of Antimalarials. Bangkok: Mahidol University Publications, 85–125.
  12. Dua VK, Gupta NC, Kar PK, Nand J, Sharma VP, Subbarao SK, 2000. Chloroquine and desethylchloroquine concentrations in blood cells and plasma from Indian patients infected with sensitive or resistant Plasmodium falciparum. Ann Trop Med Parasitol 94 : 565–570.
    [Google Scholar]
  13. Ward SA, Bray PG, Hawley SR, 1997. Quinoline resistance mechanisms in Plasmodium falciparum: the debate goes on. Parasitol. 114 (Suppl): 125–136.
    [Google Scholar]
  14. Sharma VP, 2000. Status of drug resistance in malaria in India. Mahajan RC, ed. Multi-Drug Resistance in Emerging and ReEmerging Diseases. Delhi: Narosa Publications, 191–202.
  15. Smithuis FM, Monti F, Grundl M, Oo AZ, Kyaw TT, Phe O, White NJ, 1997. Plasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar. Trans R Soc Trop Med Hyg 91 : 468–472.
    [Google Scholar]

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  • Received : 19 Nov 2002
  • Accepted : 22 May 2003
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