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Sensitivity of Plasmodium vivax to chloroquine, mefloquine, artemisinin and atovaquone in north-western Thailand

Sensibilität von Plasmodium vivax gegenüber Chloroquin, Mefloquin, Artemisinin und Atovaquon im Nordwesten Thailands

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Zusammenfassung

Mit Ausnahme des tropischen Teils von Afrika, ist Plasmodium vivax die in Asien und Lateinamerika häufigste Ursache der Malaria. Im Verbreitungsgebiet des Chesson-Stammes von P. vivax wurde 1989 erstmals Chloroquin-Resistenz beschrieben. Seither sind mehrere Berichte auch aus anderen Gegenden der Welt erschienen. Diese Studie hatte das Ziel, die Empfindlichkeit von P. vivax gegenüber Chloroquin und möglichen Alternativmedikamenten im Westen Thailands zu messen. Die Arbeiten fanden 2008 in Mae Sot, Tak Provinz, Thailand statt und folgten der Methode von Tasanor. Die IC50 und IC90 Werte für Chloroquin beliefen sich auf 167 nM und 5445 nM, jene für Mefloquin auf 139 nM und 5282 nM, während sie für Artemisinin bei 32 nM und 466 nM und für Atovaquon bei 30 nM und 650 nM lagen. Diese Werte weisen auf baldigen oder bereits erfolgten Eintritt der Chloroquin-Resistenz hin. Auch der alternative Einsatz von Mefloquin erübrigt sich auf Grund hoher Resistenzwerte. Dem gegenüber stellt Atovaquon, zusammen mit Proguanil, eine mögliche Alternative dar.

Summary

Excepting tropical Africa, where Plasmodium falciparum prevails, Plasmodium vivax is the most frequent cause of malaria in Asia and Latin America. First reliable reports of chloroquine resistance came in 1989 from the area of the distribution of the Chesson-strain of P. vivax. Since then, reports also came from other areas of the world. This study had the objective of measuring the sensitivity of P.vivax to chloroquine and potential alternative compounds in western Thailand. The study was performed in 2008 in Mae Sot, Tak Province, and followed the method of Tasanor. The IC50 and IC90 values for chloroquine were 167 nM and 5445 nM, those for mefloquine were 139 nM and 5282 nM, those for artemisinin were 32 nM and 466 nM, and those for atovaquone 30 nM and 650 nM. The values for chloroquine indicate the existing or imminent occurrence of specific resistance. High prevalence of mefloquine resistance precludes its alternative use. However, atovaquone, in combination with proguanil, may be a possible alternative.

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Authors and Affiliations

  1. Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Immunology and Infectiology, Medical University of Vienna, Vienna, Austria

    Moritz Treiber, Ursula Wiedermann & Walther H. Wernsdorfer

  2. Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

    Gunther Wernsdorfer

  3. Directorate of Vector-borne Disease Control, Ministry of Public Health, Nonthaburi, Thailand

    Kanungnit Congpuong & Jeeraphat Sirichaisinthop

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  1. Moritz Treiber
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  2. Gunther Wernsdorfer
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  3. Ursula Wiedermann
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  4. Kanungnit Congpuong
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  5. Jeeraphat Sirichaisinthop
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  6. Walther H. Wernsdorfer
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Correspondence to Walther H. Wernsdorfer.

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Treiber, M., Wernsdorfer, G., Wiedermann, U. et al. Sensitivity of Plasmodium vivax to chloroquine, mefloquine, artemisinin and atovaquone in north-western Thailand. Wien Klin Wochenschr 123 (Suppl 1), 20–25 (2011). https://doi.org/10.1007/s00508-011-0044-6

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  • DOI: https://doi.org/10.1007/s00508-011-0044-6

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