Henry M C, Docters van Leeuwen W, Watson P, Jansen A, Jacobs K, Zwart F, Agricola K, Nahounou N, Dossou J, Eggelte T E
Department of Epidemiology and Public Health, Wageningen Agricultural University (WAU), The Netherlands.
Acta Trop. 1994 Dec;58(3-4):275-81. doi: 10.1016/0001-706x(94)90021-3.
In vivo testing of Plasmodium falciparum sensitivity to chloroquine was carried out in four rural sites of differing socio-geographical environment in Côte d'Ivoire. Of a total of 1282 patients of all ages with fever or previous history of fever, 649 were slide positive, with 435 patients with a pure P. falciparum infection; 191 fulfilled all the criteria for inclusion in this study, and 113 completed it. Treatment failure rates ranged from 9.7% (Djébonoua) to 38.1% (Tiéviéssou), and were most often associated with higher degrees of resistance (RII = 54.2%; RIII = 37.5%). Blood chloroquine levels measured by ELISA test suggest that many people take chloroquine routinely; furthermore 37.5% of resistance cases occurred in subjects who had high blood chloroquine concentrations on day 0. Twenty-three out of 24 cases of resistance were found in children under 7 years of age. Nearly all children with persisting parasitaemia were afebrile on day 7, even those (7/8) with RIII resistance. Children aged < 7 years represent the the best sentinel group for monitoring P. falciparum sensitivity to chloroquine in Côte d'Ivoire.
在科特迪瓦四个社会地理环境不同的农村地区对恶性疟原虫对氯喹的敏感性进行了体内测试。在总共1282名有发热或既往发热史的各年龄段患者中，649名患者血涂片呈阳性，其中435名患者为单纯恶性疟原虫感染；191名患者符合本研究的所有纳入标准，113名患者完成了研究。治疗失败率从9.7%（杰博努阿）到38.1%（蒂耶维苏）不等，且大多与更高程度的耐药性相关（RII = 54.2%；RIII = 37.5%）。通过酶联免疫吸附测定试验测得的血氯喹水平表明，许多人经常服用氯喹；此外，37.5%的耐药病例发生在第0天血氯喹浓度较高的受试者中。24例耐药病例中有23例出现在7岁以下儿童中。几乎所有持续性寄生虫血症的儿童在第7天均无发热，即使是那些具有RIII耐药性的儿童（8例中的7例）。在科特迪瓦，7岁以下儿童是监测恶性疟原虫对氯喹敏感性的最佳哨兵群体。
