Centro Internacional de Entrenamiento en Investigaciones Médicas, Cali, Colombia.
Mem Inst Oswaldo Cruz. 2011 Aug;106 Suppl 1:123-9. doi: 10.1590/s0074-02762011000900016.
Drug resistance is one of the principal obstacles blocking worldwide malaria control. In Colombia, malaria remains a major public health concern and drug-resistant parasites have been reported. In vitro drug susceptibility assays are a useful tool for monitoring the emergence and spread of drug-resistant Plasmodium falciparum. The present study was conducted as a proof of concept for an antimalarial drug resistance surveillance network based on in vitro susceptibility testing in Colombia. Sentinel laboratories were set up in three malaria endemic areas. The enzyme linked immunosorbent assay-histidine rich protein 2 and schizont maturation methods were used to assess the susceptibility of fresh P. falciparum isolates to six antimalarial drugs. This study demonstrates that an antimalarial drug resistance surveillance network based on in vitro methods is feasible in the field with the participation of a research institute, local health institutions and universities. It could also serve as a model for a regional surveillance network. Preliminary susceptibility results showed widespread chloroquine resistance, which was consistent with previous reports for the Pacific region. However, high susceptibility to dihydroartemisinin and lumefantrine compounds, currently used for treatment in the country, was also reported. The implementation process identified critical points and opportunities for the improvement of network sustainability strategies.
耐药性是阻碍全球疟疾控制的主要障碍之一。在哥伦比亚，疟疾仍然是一个主要的公共卫生关注点，已经报告了耐药寄生虫。体外药物敏感性检测是监测抗疟原虫药物耐药性寄生虫出现和传播的有用工具。本研究旨在基于哥伦比亚的体外药敏试验建立抗疟药耐药监测网络的概念验证。在三个疟疾流行地区设立了哨点实验室。使用酶联免疫吸附试验-组氨酸丰富蛋白 2 和裂殖体成熟方法评估新鲜疟原虫分离株对六种抗疟药物的敏感性。本研究表明，在研究机构、当地卫生机构和大学参与的情况下，基于体外方法的抗疟药耐药监测网络在现场是可行的。它还可以作为区域监测网络的模型。初步的药敏结果显示广泛的氯喹耐药性，这与以前报道的太平洋地区的结果一致。然而，也报告了该国目前用于治疗的青蒿素类和哌喹化合物的高敏感性。实施过程确定了网络可持续性策略改进的关键点和机会。
