Wiener klinische Wochenschrift

, Volume 120, Supplement 4, pp 63–68 | Cite as

Malariological baseline survey and in vitro antimalarial drug resistance in Gulu district, Northern Uganda

  • Christof Prugger
  • Michael Engl
  • Martin Ogwang
  • Franz Ploner
  • Martin Ploner
  • Doris Gluderer
  • Gunther Wernsdorfer
  • Walther H. Wernsdorfer
  • Malaria Monitoring Study Group
Original Article

Summary

A comprehensive, representative malaria survey has been carried out in a population of internally displaced persons (IDP) in the district of Gulu, Northern Uganda. It included 74 households and 390 persons, and covered socio-economic and environmental information, individual physical data, malaria and the drug sensitivity of Plasmodium falciparum. The prevalence of infections with Plasmodium falciparum was 54.4% at a geometric mean asexual parasitaemia of 229/µl blood, typical for hyperendemic conditions. P. falciparum turned out to be highly resistant to chloroquine and amodiaquine. It showed also reduced sensitivity against lumefantrine and artemisinin, obviously the result of the liberal use of the lumefantrine-artemether combination without evidence-based indication.

Keywords

Malaria Prevalence Plasmodium falciparum Drug sensitivity Uganda 

Malariologische Basisuntersuchung und in vitro Resistenzprüfung im Distrikt Gulu, Nord-Uganda

Zusammenfassung

Eine umfassende, repräsentative Basisuntersuchung über Malaria wurde in einer Flüchtlingspopulation im Distrikt Gulu im Norden Ugandas durchgeführt. Die Studie schloss 74 Haushalte und 390 Personen ein. Die erfassten Parameter erstreckten sich auf sozio-ökonomische Information, Umwelt, individuelle physische Daten, Malaria und die Arzneimittelempfindlichkeit von Plasmodium falciparum. Die Prävalenz von Infektionen mit Plasmodium falciparum betrug 54.4% mit einer mittleren asexuellen Parasitämie von 229/µl Blut, ein Hinweis auf hyperendemischen Status. P. falciparum zeigte hochgradige Resistenz gegen Chloroquin und Amodiaquin und bereits reduzierte Sensibilität gegenüber Lumefantrin und Artemisinin, offensichtlich das Resultat freizügigen Einsatzes der Lumefantrin-Artemether Kombination ohne die Basis evidenzgesteuerter Indikation.

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References

  1. World Health Organisation (2006) Health Action in Crises: 2006 Strategy Paper. GenevaGoogle Scholar
  2. World Health Organisation (2004) Uganda: Last Update. Geneva; www.who.int/disasters/repo/15110.pdf. Last assessed: 2008-02-12
  3. World Health Organisation (2005) Health and mortality survey among internally displaced persons in Gulu, Kitgum and Pader districts, Northern Uganda. GenevaGoogle Scholar
  4. Accorsi S, Fabiani M, Lukwiya M, Onek PA, Di Mattei P, Declich S (2001) The increasing burden of infectious diseases on hospital services at St Mary's Hospital Lacor, Gulu, Uganda. Am J Trop Med Hyg 64: 154–158PubMedGoogle Scholar
  5. Miller LH, Baruch DI, Marsh K, Doumbo OK (2002) The pathogenic basis of malaria. Nature 415: 673–679PubMedCrossRefGoogle Scholar
  6. Onori E (1967) Distribution of Plasmodium ovale in the eastern, western and northern regions of Uganda. Bull World Health Organ 37: 665–668PubMedGoogle Scholar
  7. Kolaczinski JH, Ojok N, Opwonya J, Meek S, Collins A (2006) Adherence of community caretakers of children to pre-packaged antimalarial medicines (HOMAPAK) among internally displaced people in Gulu district, Uganda. Malar J 5: 40–49PubMedCrossRefGoogle Scholar
  8. President's Malaria Initiative Uganda. Operational Plan (MOP) FY 2007; www.fightingmalaria.gov/countries/uganda_mop-fy07.pdf. Last assessed: 2008-02-12
  9. Lemeshow S, Robinson D (1985) Surveys to measure programme coverage and impact: a review of the methodology used by the expanded programme on immunization. World Health Stat Quart 38: 65–75Google Scholar
  10. World Health Organisation (2005) Malaria Indicator Survey: Basic Documentation for Survey Design and Implementation. GenevaGoogle Scholar
  11. Hackett LW (1944) Spleen measurement in malaria. Journal of the National Malaria Society: 121–123Google Scholar
  12. World Health Organisation (2006) WHO Child Growth Standards. Methods and development. GenevaGoogle Scholar
  13. World Health Organisation (2000) Obesity: Preventing and managing the global epidemic. Technical Report Series 894. GenevaGoogle Scholar
  14. Nathan DG, Oski FA (1993) Hematology of infancy and childhood, 4th edn. PhiladelphiaGoogle Scholar
  15. Litchfield JT jr, Wilcoxon F (1949) A simplified method of evaluating dose-effect experiments. J Pharm Exp Ther 96: 99–113Google Scholar
  16. Wernsdorfer WH, Wernsdorfer MG (1995) The evaluation of in vitro tests for the assessment of drug response in Plasmodium falciparum. Mitteil Oesterr Gesellsch Tropenmed Parasitol 17: 221–228Google Scholar
  17. Wernsdorfer WH, Landgraf B, Kilimali VA, Wernsdorfer G (1998) Activity of benflumetol and its enantiomers in fresh isolates of Plasmodium falciparum from East Africa. Acta Tropica 70: 9–15PubMedCrossRefGoogle Scholar
  18. Wernsdorfer WH, Congpuong K, Sirichaisinthop J, Wernsdorfer G (2007) Drug sensitivity of Plasmodium falciparum and vivax in the area of Mae Sot, Tak Province, northwestern Thailand. Trop Med Health 35: 1–9CrossRefGoogle Scholar
  19. Zatloukal C, Woitsch B, Noedl H, Prajakwong S, Wernsdorfer G, Wernsdorfer WH (1998) Longitudinale Beobachtungen über die Artemisininempfindlichkeit von Plasmodium falciparum in Thailand. Mitteil Oesterr Gesellsch Tropenmed Parasitol 20: 165–170Google Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Christof Prugger
    • 1
  • Michael Engl
    • 2
    • 3
  • Martin Ogwang
    • 4
  • Franz Ploner
    • 3
  • Martin Ploner
    • 2
  • Doris Gluderer
    • 3
  • Gunther Wernsdorfer
    • 5
  • Walther H. Wernsdorfer
    • 2
  • Malaria Monitoring Study Group
  1. 1.Institute of Epidemiology and Social MedicineUniversity of MünsterMünsterGermany
  2. 2.Institute of Specific Prophylaxis and Tropical Medicine, Centre for Physiology and PathophysiologyVienna Medical UniversityViennaAustria
  3. 3.Hospital SterzingSterzingItaly
  4. 4.St. Mary's Hospital LacorGuluUganda
  5. 5.Faculty of Tropical MedicineMahidol UniversityBangkokThailand

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