Makono R, Sibanda S
Department of Chemistry, University of Zimbabwe, Harare, Zimbabwe.
Trans R Soc Trop Med Hyg. 1999 Sep-Oct;93(5):449-52. doi: 10.1016/s0035-9203(99)90331-0.
The response of Plasmodium falciparum malaria to antimalarial drugs, mainly chloroquine, the first-line drug of choice for the treatment of malaria in Zimbabwe is reported here for the period 1984-96. Earlier studies (1982-83) had shown that Zimbabwe was free from drug-resistant falciparum malaria. The first chloroquine-resistant cases of malaria were reported in 1984 in the Zambezi Valley in the north-east of Zimbabwe. Following this report several cases of chloroquine resistance have been reported throughout the malaria-endemic regions of the country thus prompting the Ministry of Health to develop a sustainable national surveillance strategy to monitor, on an annual basis, the spread and extent of P. falciparum resistance to antimalarial drugs available to the National Malaria Control Programme (NMCP). Of all the antimalarial drugs assessed in vivo, only chloroquine and halofantrine have shown resistance, while no resistance in vivo was observed for sulfadoxine-pyrimethamine (Fansidar), quinine and mefloquine. The study shows the need to replace chloroquine with alternative antimalarial drugs in areas where chloroquine resistance is high, and an increase in the drug pool against malaria is also recommended considering that all the alternative antimalarial drugs available to the NMCP have faced resistance in various parts of the world.
本文报告了1984 - 1996年期间，恶性疟原虫疟疾对抗疟药物（主要是氯喹，津巴布韦治疗疟疾的一线首选药物）的反应情况。早期研究（1982 - 1983年）表明，津巴布韦不存在耐药性恶性疟原虫疟疾。1984年，在津巴布韦东北部的赞比西河谷首次报告了氯喹耐药性疟疾病例。此后，该国疟疾流行地区陆续报告了多例氯喹耐药病例，促使卫生部制定一项可持续的国家监测战略，以便每年监测恶性疟原虫对国家疟疾控制规划（NMCP）所用抗疟药物的耐药性传播情况和程度。在所有经体内评估的抗疟药物中，只有氯喹和卤泛群显示出耐药性，而磺胺多辛 - 乙胺嘧啶（Fansidar）、奎宁和甲氟喹在体内未观察到耐药性。该研究表明，在氯喹耐药性较高的地区，有必要用替代抗疟药物取代氯喹，鉴于NMCP所用的所有替代抗疟药物在世界不同地区都面临耐药性问题，还建议增加抗疟药物储备。
