Ghosh S K, Yadav R S, Sharma V P
Malaria Research Centre (Field Station), Rourkela, India.
Indian J Malariol. 1992 Dec;29(4):211-8.
In a malaria-endemic area of Orissa, wherein chloroquine has been in use for over thirty years, 58.3% (14/24) P. falciparum cases did not respond to single dose chloroquine (10 mg base/kg) in in-vivo test. With standard dose (25 mg base/kg) 31.2% cases (10/32) showed resistance, i.e. at RI (15.6%), RII (9.4%) and RIII (6.2%) levels. Standard dose was superior in response to the single dose therapy [p < 0.05; chi 2 (df 1) = 4.11]. Out of eight isolates tested in vitro, two showed resistance to chloroquine, five to sulfadoxine/pyrimethamine (SP) but all were sensitive to amodiaquine, quinine and mefloquine. Whereas the standard dose of chloroquine would be a better option in general, in resistant cases, SP, quinine and mefloquine offer an alternative drug choice. The implications of drug resistance in a malaria-control programme and the need to revise drug policy in India are discussed.
在奥里萨邦一个疟疾流行地区，氯喹已使用三十多年，在体内试验中，58.3%（14/24）的恶性疟原虫病例对单剂量氯喹（10毫克碱基/千克）无反应。使用标准剂量（25毫克碱基/千克）时，31.2%的病例（10/32）显示耐药，即耐药水平为RI（15.6%）、RII（9.4%）和RIII（6.2%）。标准剂量治疗的反应优于单剂量治疗[p < 0.05；卡方检验（自由度1）= 4.11]。在体外测试的8个分离株中，2个对氯喹耐药，5个对磺胺多辛/乙胺嘧啶（SP）耐药，但所有分离株对阿莫地喹、奎宁和甲氟喹敏感。虽然一般来说氯喹标准剂量是更好的选择，但对于耐药病例，SP、奎宁和甲氟喹可作为替代药物选择。本文讨论了耐药性对疟疾控制规划的影响以及印度修订药物政策的必要性。
