抗疟药在阿鲁纳恰尔邦印缅边境地区恶性疟原虫疟疾中的治疗效果。

Therapeutic efficacy of anti-malarials in Plasmodium falciparum malaria in an Indo-Myanmar border area of Arunachal Pradesh.

作者信息

Mohapatra P K, Namchoom N S, Prakash Anil, Bhattacharya D R, Goswami B K, Mahanta J

机构信息

Regional Medical Research Centre (ICMR), NE Region, Dibrugarh, India.

出版信息

Indian J Med Res. 2003 Aug;118:71-6.

PMID:14680202

Abstract

BACKGROUND & OBJECTIVES: Malaria is one of the major public health problems in the north eastern region of India. Antimalarial drug resistance is widespread and one of the important causes of recent resurgence of falciparum malaria in this region. Antimalarial drugs are seen to be used sequentially one after another in many areas of the region, when therapeutic failure is observed with a drug. In view of this, the present study was undertaken to assess the therapeutic efficacy of common antimalarial drugs viz., chloroquine, sulfadoxine+pyrimethamine (S-P) and quinine, administered sequentially to the patients with Plasmodium falciparum infection in a Myanmar bordering area of Arunachal Pradesh.

METHODS

A hospital based in vivo study was carried out with 53 patients with uncomplicated falciparum malaria. All patients were first treated with chloroquine and therapeutic efficacy assessed. In case of therapeutic failure of chloroquine combination drug (S-P) was given and those showing failure with S-P combination, oral quinine was administered and followed up for 28 days to assess both clinical and parasitological responses.

RESULTS

Therapeutic failure was observed with chloroquine in 83.1 per cent (44 of 53) and to both chloroquine and S-P combination drug in 44.1 per cent (19/43) patients. Further, 15.8 per cent patients (3 of 19) failed to respond even to quinine. Overall, 5.7 per cent patients (3 of 53) showed unresponsiveness to all the three drugs i.e., chloroquine, S-P combination and quinine. Asexual parasite clearance and also fever clearance was slowest with chloroquine and fastest with quinine.

INTERPRETATION & CONCLUSION: The findings of this study show the presence of multi drug failure P. falciparum in Jairampur-Nampong, a western Myanmar bordering area of Arunachal Pradesh. Anti malarial drug resistance is increasing in Indo-Myanmar border areas and systematic studies need to be done to review the situation.

摘要

背景与目的

疟疾是印度东北地区主要的公共卫生问题之一。抗疟药物耐药性广泛存在，是该地区近期恶性疟再度流行的重要原因之一。在该地区许多地方，当观察到一种药物治疗失败时，抗疟药物会依次相继使用。鉴于此，本研究旨在评估在阿鲁纳恰尔邦与缅甸接壤地区，对恶性疟原虫感染患者依次给予常用抗疟药物，即氯喹、周效磺胺 + 乙胺嘧啶（S-P）和奎宁的治疗效果。

方法

对53例非复杂性恶性疟患者进行了一项基于医院的体内研究。所有患者首先接受氯喹治疗并评估治疗效果。若氯喹治疗失败，则给予联合药物（S-P），若S-P联合治疗失败，则给予口服奎宁，并随访28天以评估临床和寄生虫学反应。

结果

83.1%（53例中的44例）患者氯喹治疗失败，44.1%（43例中的19例）患者氯喹和S-P联合药物治疗均失败。此外，15.8%的患者（19例中的3例）对奎宁也无反应。总体而言，5.7%的患者（53例中的3例）对所有三种药物，即氯喹、S-P联合药物和奎宁均无反应。无性寄生虫清除以及发热清除以氯喹最慢，以奎宁最快。