Quashie N B, Duah N O, Abuaku B, Koram K A
Noguchi Memorial Institute for Medical Research, University of Ghana, PO Box LG 581, Legon, Accra, Ghana.
Ann Trop Med Parasitol. 2007 Jul;101(5):391-8. doi: 10.1179/136485907X176553.
In Ghana in 2004 (when choroquine was still the nationally recommended drug for the first-line treatment of malaria), the sensitivities, to chloroquine, amodiaquine, quinine, mefloquine, artesunate and halofantrine, of 60 Plasmodium falciparum isolates from two ecologically distinct areas of the country were assessed in vitro. The aim was to make available, to policy-makers, the field-based evidence needed to review the national strategy for malaria treatment. Drug susceptibilities were explored using the standardized protocol of the Antimalarial Drug Resistance Network. Although 32 of the P. falciparum isolates evaluated (56.1% of the 57 isolates successfully investigated for their susceptibility to choroquine) showed resistance to chloroquine and two showed slightly reduced sensitivity to amodiaquine, all the isolates were sensitive to mefloquine, artesunate, quinine and halofantrine. The median inhibitory concentrations (IC(50)) of chloroquine were positively correlated with those of quinine (r=0.4528; P=0.0008) but not those of any of the other drugs investigated. The IC(50) of amodiaquine and artesunate were also positively correlated (r=0.3703; P=0.0067). These results provide evidence of the presence, in Ghana, of P. falciparum isolates that are highly resistant to chloroquine but generally sensitive to most of the other antimalarial drugs commonly used in the country. Partly in consequence of these observations, the recommended first-line treatment for malaria in Ghana was changed to an amodiaquine-artesunate combination in January 2005.
2004年在加纳（当时氯喹仍是全国推荐用于疟疾一线治疗的药物），对该国两个生态环境不同地区的60株恶性疟原虫分离株进行了氯喹、氨酚喹、奎宁、甲氟喹、青蒿琥酯和卤泛群的体外敏感性评估。目的是为政策制定者提供审查国家疟疾治疗战略所需的实地证据。使用抗疟药物耐药性网络的标准化方案探索药物敏感性。尽管评估的32株恶性疟原虫分离株（在成功调查氯喹敏感性的57株分离株中占56.1%）显示对氯喹耐药，2株对氨酚喹敏感性略有降低，但所有分离株对甲氟喹、青蒿琥酯、奎宁和卤泛群均敏感。氯喹的半数抑制浓度（IC50）与奎宁的半数抑制浓度呈正相关（r=0.4528；P=0.0008），但与所研究的其他任何药物的半数抑制浓度均无相关性。氨酚喹和青蒿琥酯的IC50也呈正相关（r=0.3703；P=0.0067）。这些结果证明，在加纳存在对氯喹高度耐药但对该国常用的大多数其他抗疟药物普遍敏感的恶性疟原虫分离株。部分由于这些观察结果，加纳于2005年1月将推荐的疟疾一线治疗改为氨酚喹-青蒿琥酯联合用药。
