Schuurkamp G J, Kereu R K
P N G Med J. 1989 Mar;32(1):33-44.
In the North Fly region of the Western Province of Papua New Guinea 491 cases of Plasmodium falciparum infection were monitored in vivo for sensitivity to chloroquine and amodiaquine over a 2-year period; 41% resistance was detected. The RI type accounted for 74% of the resistant strains detected; 43% of these recrudesced on day 28 or shortly thereafter. 22% of resistant strains were RII type and 4% R III. The infections were categorized as imported or locally acquired. Imported infections accounted for 58% of the cases monitored and showed a resistance rate of 49%. Resistance was detected in 24% of the cases indigenous to the North Fly region (13% in the Kiunga-Ningerum area and 38% in the Ok Tedi-Star Mountains area). Linguistic groups immediate to the Ok Tedi mining operation, the Wopkaimin and Kamfaiwolmin, showed an increase in resistance from 28% in 1986 to 55% the following year. This increase was associated with renewed construction activity within the mine's development area. Two falciparum malaria outbreaks were experienced during this study, the second being attributed to introduced strains. The study showed the impact of age and variation of malaria endemicity in suppressing resistance. The study also demonstrated a possible cross-resistance problem between imported cases of P. falciparum treated with amodiaquine and chloroquine, with resistance rates of 58% and 60%, respectively, demonstrated in children under 10 years of age. The 61% amodiaquine resistance rate in locally acquired infection in children was attributed to drug pressure, since chloroquine resistance in the same group was reported at 19%. RIII-type resistance in children was only detected in those treated with amodiaquine. The efficacy of amodiaquine in clearing only 41% of the P. falciparum infections in children was a major concern. All 201 resistant P. falciparum infections detected over the 24-month monitoring period responded to treatment with quinine and Fansidar.
在巴布亚新几内亚西部省份的北弗莱地区，对491例恶性疟原虫感染病例进行了为期两年的体内氯喹和氨酚喹敏感性监测；检测到41%的耐药率。RI型占检测到的耐药菌株的74%；其中43%在第28天或此后不久复发。22%的耐药菌株为RII型，4%为RIII型。感染分为输入性或本地获得性。输入性感染占监测病例的58%，耐药率为49%。在北弗莱地区本土病例中检测到24%的耐药率（在基温加 - 宁盖鲁姆地区为13%，在奥克泰迪 - 斯塔山地区为38%）。紧邻奥克泰迪采矿作业区的语言群体，即沃普凯明族和坎法伊沃尔明族，耐药率从1986年的28%上升至次年的55%。这种上升与矿区开发区内重新开展的建设活动有关。在本研究期间经历了两次恶性疟爆发，第二次归因于引入的菌株。该研究显示了年龄和疟疾流行程度变化对抑制耐药性的影响。该研究还证明了用氨酚喹和氯喹治疗的输入性恶性疟病例之间可能存在交叉耐药问题，在10岁以下儿童中耐药率分别为58%和60%。儿童本地获得性感染中61%的氨酚喹耐药率归因于药物压力，因为同一组中氯喹耐药率报告为19%。仅在接受氨酚喹治疗的儿童中检测到RIII型耐药。在24个月的监测期内检测到的所有201例耐药恶性疟感染病例对奎宁和 Fansidar治疗均有反应。
