1921
Volume 75, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

In terms of drug resistance Bangladesh acts as an important gateway to the Indian Subcontinent. However, little is known about the current status of drug resistance in this country. The aim of this study was therefore to determine the therapeutic efficacy as well as drug sensitivity of quinine for 3 days plus a single dose of sulfadoxine/pyrimethamine (Q3F), an affordable alternative to the previously used chloroquine, for the treatment of uncomplicated falciparum malaria. Sixty-three patients were enrolled in the study; the overall cure rate in a 42-day follow-up after PCR adjustment was 87.3% (95% CI: 77.6–94.1). One patient was classified as early treatment failure (1.7%, 95% CI: 0.0–8.9%); 6 patients (10%; 95% CI: 3.8–20.5%) had late treatment failures within a median time of 27 days. HRP2 drug sensitivity tests were performed on all samples. Significantly higher ( = 0.008) ICs for pyrimethamine in treatment failures reflect the somewhat compromised drug sensitivity to this drug. These data suggest that the combination of 3 days of quinine with a single dose of sulfadoxine/pyrimethamine is an interesting and affordable alternative as long as or whenever ACT is not available.

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2006-10-01
2017-09-21
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References

  1. World Health Organization, 2005. World Malaria Report. http://rbm.who.int/wmr2005/profiles/bangladesh.pdf. Accessed 14 July 2005.
  2. Bangali AM, Atoul Huq Mahmood M, Rahman M, 2000. The malaria situation in Bangladesh. Mekong Malaria Forum 6 : 16–23.
  3. Faiz MA, Yunus EB, Rahman MR, Hossain MA, Pang LW, Rahman ME, Bhuiyan SN, 2002. Failure of national guidelines in diagnose uncomplicated malaria in Bangladesh. Am J Trop Med Hyg 67 : 396–399.
  4. World Health Organization, 2003. Assessment and monitoring of antimalarial drug efficiency for the treatment of uncomplicated falciparum malaria. Geneva World Health Organization. Document WHO/HTM/RBM/2003.50.
  5. Noedl H, Attlmayr B, Wernsdorfer WH, Kollaritsch H, Miller RS, 2004. A histidine-rich-protein 2-based malaria drug sensitivity assay for field use. Am J Trop Med Hyg 71 : 711–714.
  6. Noedl H, Bronnert J, Yingyuen K, Attlmayr B, Kollaritsch H, Fukuda M, 2005. Simple histidine-rich protein 2 double-site sandwich enzyme-linked immunosorbent assay for use in malaria drug sensitivity testing. Antimicrob Agents Chemother 49 : 3575–3577.
  7. Noedl H, Wernsdorfer WH, Miller RS, Wongsrichanalai C, 2002. Histidine-rich protein II: a novel approach to malaria drug sensitivity testing. Antimicrob Agents Chemother 46 : 1658–1664.
  8. Rahman MR, Hassan MR, Faiz MA, Paul B, Jalil MA, 1998. Monitoring efficacy of commonly used antimalarials by a 14-day in-vivo test in a new settler’s camp in endemic zone at Cox’s Bazar. Bangladesh Med Res Counc Bull 24 : 67–74.
  9. Rahman MR, Paul DC, Rashid M, Ghosh A, Bangali AM, Jalil MA, Faiz MA, 2001. A randomized controlled trial on the efficacy of alternative treatment regimens for uncomplicated falciparum malaria in a multi-drug resistant falciparum area of Bangladesh—narrowing the options for the National Malaria Control Programme? Trans R Soc Trop Med Hyg 95 : 661–667.
  10. Feikin DR, Dowell SF, Nwanyanwu OC, Klugman KP, Kazembe PN, Barat LM, Graf C, Bloland PB, Ziba C, Huebner RE, Schwartz B, 2000. Increased carriage of trimethoprim/ sulfamethazole-resistant Streptococcus pneumoniae in Malawian children after treatment for malaria with sulfadoxine/ pyrimethamine. J Infect Dis 181 : 1501–1505.
  11. Thera MA, Sehdev PS, Coulibaly D, Traore K, Garba MN, Cissko Y, Kone A, Guindo A, Dickko A, Beavogui AH, Djimde AA, Lyke KE, Diallo DA, Doumbo OK, Plowe CV, 2005. Impact of trimethoprim-sulfamethoxazole prophylaxis on falciparum malaria infection and disease. J Infect Dis 192 : 1823–1829.
  12. Van den Broek IV, Maung UA, Peters A, Liem L, Kamal M, Rahman M, Rahman MR, Bangali AM, Das S, Barends M, Faiz AM, 2005. Efficacy of chloroquine + sulfadoxine–pyrimethamine, mefloquine + artesunate and artemether + lumefantrine combination therapies to treat Plasmodium falciparum malaria in the Chittagong Hill Tracts, Bangladesh. Trans R Soc Trop Med Hyg 99 : 727–735.
  13. Noedl H, Faiz MA, Yunus EB, Rahman MR, Hossain MA, Samad R, Miller RS, Pang LW, Wongsrichanalai C, 2003. Drug-resistant malaria in Bangladesh: an in vitro assessment. Am J Trop Med Hyg 68 : 140–142.
  14. Rosenberg R, Maheswary NP, 1977. Chloroquine resistant Plasmodium falciparum in Bangladesh. Trans R Soc Trop Med Hyg 70 : 533.
  15. Van den Broeck IV, van der Wardt S, Talukder L, Chakma S, Brockman A, Nair S, Anderson TC, 2004. Drug resistance in Plasmodium falciparum from the Chittagong Hill Tracts, Bangladesh. Trop Med Int Health 9 : 680–687.
  16. Mabuza A, Govere J, Durrheim D, Mngomezulu N, Bredenkamp B, Barnes K, Sharp B, 2001. Therapeutic efficacy of sulfadoxine-pyrimethamin in uncomplicated Plasmodium falciparum malaria 3 years after introduction in Mpumalanga. S Afr Med J 91 : 975–978.
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  • Received : 09 Mar 2006
  • Accepted : 13 May 2006

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