Guéret D, Migot F, Ringwald P, Thibaut P, Le Bras J
Hôpital J.C. Andrault, COMUF, Mounana, Gabon.
Bull World Health Organ. 1992;70(5):621-4.
Between 1987 and 1989 the trend in the chloroquine resistance of Plasmodium falciparum in the mining town of Mounana in south-eastern Gabon was studied in vivo and in vitro in 58 and 158 subjects, respectively, aged from 1 to 15 years. The tests used were a simplified variant of the standard WHO 7-day test for the in vivo study and the isotopic semi-microtest of chemosensitivity for the in vitro study. The health situation in 1989 showed no change from the 1987 situation, but an increase in febrile symptoms suggestive of malaria was observed in 1989. This observation may be linked to a decrease in the distribution of chloroquine since 1987, accompanied by the use of other antimalarials following the appearance of chloroquine-resistant strains. While the parasitological efficacy in vivo remained the same in 1989, there was a decrease in the proportion of strains resistant to chloroquine in vitro compared to 1987; likewise, the therapeutic efficacy as estimated from temperature readings was better in 1989 than in 1987: the modification of the prophylactic strategy since 1986 and the drop in chloroquine consumption since 1987 could be responsible for a stabilization of chloroquine resistance at Mounana. The authors consider it appropriate in this region to continue treating malaria in children with chloroquine (in a dosage of 25 mg/kg) and to use a second-line treatment in the event of the recurrence of malaria symptoms within the next two weeks.
1987年至1989年期间，在加蓬东南部矿业城镇穆纳纳，分别对58名和158名年龄在1至15岁之间的受试者进行了体内和体外研究，以了解恶性疟原虫对氯喹的抗药性趋势。体内研究采用的试验是世界卫生组织标准7天试验的简化变体，体外研究采用化学敏感性同位素半微量试验。1989年的健康状况与1987年相比没有变化，但1989年观察到提示疟疾的发热症状有所增加。这一观察结果可能与自1987年以来氯喹的分发量减少有关，随着耐氯喹菌株的出现，其他抗疟药的使用也随之增加。虽然1989年体内寄生虫学疗效保持不变，但与1987年相比，体外对氯喹耐药的菌株比例有所下降；同样，根据体温读数估计的治疗效果在1989年比1987年更好：自1986年以来预防策略的改变以及自1987年以来氯喹消费量的下降可能是穆纳纳氯喹抗药性稳定的原因。作者认为，在该地区，继续用氯喹（剂量为25毫克/千克）治疗儿童疟疾，并在接下来两周内疟疾症状复发时使用二线治疗是合适的。
