Menard Didier, Djalle Djibrine, Manirakiza Alexandre, Yapou Ferdinand, Siadoua Valerie, Sana Serge, Matsika-Claquin Marcelle Diane, Nestor Madji, Talarmin Antoine
Pasteur Institute of Bangui, Bangui, Central African Republic.
Am J Trop Med Hyg. 2005 Aug;73(2):239-43.
We used an in vitro isotopic drug sensitivity assay to assess the sensitivity of Plasmodium falciparum isolates collected in Bangui, Central African Republic between March and July 2004. We tested antimalarials that are currently in use in this country (chloroquine, amodiaquine, quinine, and pyrimethamine), antimalarials that will become available in this region in the future (artemisinin and halofantrine), and prophylactic antimalarials (mefloquine, doxycycline, and atovaquone). The proportions of resistant isolates were 37% for chloroquine, 15.9% for amodiaquine, 0% for quinine, 0% for dihydroartemisinin, 1.6% for mefloquine, 3.8% for halofantrine, 4.0% for atovaquone, and 38.3% for pyrimethamine. No multi-resistant isolates (showing resistance to more than three drugs) were found. A positive correlation was found between the 50% inhibitory concentrations values for the following drugs: chloroquine and amodiaquine; quinine and halofantrine; chloroquine and dihydroartemisinin; chloroquine and halofantrine; amodiaquine and dihydroartemisinin; dihydroartemisinin and mefloquine; chloroquine and quinine; and quinine and dihydroartemisinin. These findings suggest that the Ministry of Health should recommend a interim policy with the amodiaquine plus sulfadoxine-pyrimethamine combination as the first-line antimalarial drug in Bangui until better alternative treatments such as artemisinin-based combination therapies become available at low prices in the Central African Republic.
我们采用体外同位素药物敏感性试验，评估了2004年3月至7月在中非共和国班吉采集的恶性疟原虫分离株的敏感性。我们测试了该国目前正在使用的抗疟药（氯喹、氨酚喹、奎宁和乙胺嘧啶）、该地区未来将可获得的抗疟药（青蒿素和卤泛群）以及预防性抗疟药（甲氟喹、多西环素和阿托伐醌）。耐药分离株的比例分别为：氯喹37%、氨酚喹15.9%、奎宁0%、双氢青蒿素0%、甲氟喹1.6%、卤泛群3.8%、阿托伐醌4.0%、乙胺嘧啶38.3%。未发现多重耐药分离株（对三种以上药物耐药）。在以下药物的50%抑制浓度值之间发现了正相关：氯喹和氨酚喹；奎宁和卤泛群；氯喹和双氢青蒿素；氯喹和卤泛群；氨酚喹和双氢青蒿素；双氢青蒿素和甲氟喹；氯喹和奎宁；以及奎宁和双氢青蒿素。这些研究结果表明，在中非共和国以低价获得基于青蒿素的联合疗法等更好的替代治疗方法之前，卫生部应建议一项临时政策，在班吉将氨酚喹加磺胺多辛-乙胺嘧啶联合用药作为一线抗疟药物。
