在接受氯喹预防后仍感染疟疾回国的英国旅行者中出现对氯喹耐药的恶性疟原虫感染。
Chloroquine-resistant Plasmodium falciparum infections among UK travellers returning with malaria after chloroquine prophylaxis.
作者信息
Sutherland Colin J, Haustein Thomas, Gadalla Nahla, Armstrong Margaret, Doherty Justin F, Chiodini Peter L
机构信息
Hospital for Tropical Diseases, London, UK.
出版信息
J Antimicrob Chemother. 2007 Jun;59(6):1197-9. doi: 10.1093/jac/dkm104. Epub 2007 May 2.
OBJECTIVES
We sought to identify chloroquine-resistant Plasmodium falciparum parasites among 66 travellers who presented in the UK with malaria.
METHODS
A multiplex real-time PCR assay was devised to identify wild-type and two distinct chloroquine-resistance-associated alleles of the pfcrt gene.
RESULTS
Those with documented use of chloroquine/proguanil prophylaxis were more likely to carry parasites with resistance-associated alleles of pfcrt than were patients who had been using antimalarials other than chloroquine (92.9% versus 37.5%; P = 0.011). We also found evidence that people reporting optimum compliance with chloroquine prophylaxis during malaria exposure were more common among malaria cases than were those reporting optimum compliance with other regimens (OR 3.85, 95% CI 1.61-9.69; P = 0.0008).
CONCLUSIONS
Chloroquine, known to be failing as therapy for falciparum malaria worldwide, is also failing to provide adequate malaria prophylaxis for travellers.
目的
我们试图在66名在英国患疟疾的旅行者中识别对氯喹耐药的恶性疟原虫。
方法
设计了一种多重实时聚合酶链反应检测方法，以识别野生型和两个不同的与氯喹耐药相关的pfcrt基因等位基因。
结果
有记录使用氯喹/氯胍预防的患者比使用除氯喹以外的抗疟药的患者更有可能携带具有pfcrt耐药相关等位基因的寄生虫（92.9%对37.5%；P = 0.011）。我们还发现有证据表明，在疟疾感染期间报告对氯喹预防有最佳依从性的人在疟疾病例中比报告对其他方案有最佳依从性的人更常见（比值比3.85，95%可信区间1.61 - 9.69；P = 0.0008）。
结论
已知氯喹作为全球恶性疟疾的治疗药物正在失效，它也未能为旅行者提供足够的疟疾预防。
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