Wolday D, Kibreab T, Bukenya D, Hodes R
American Joint Distribution Committee, Goma, Zaire.
Trans R Soc Trop Med Hyg. 1995 Nov-Dec;89(6):654-6. doi: 10.1016/0035-9203(95)90431-x.
Resistance of Plasmodium falciparum to available antimalarial drugs is now thought to be spreading progressively throughout sub-Sahara Africa. In this study we measured the susceptibility of P. falciparum to chloroquine and pyrimethamine-sulfadoxine in vivo in Rwandan patients living in Kibumba refugee camp in Goma, Zaire. Of the 39 cases treated with chloroquine, only 8 (20.5%) showed sensitive or RI (delayed) response and 31 (79.5%) demonstrated resistance at RI (30.8%), RII (33.3%( and RIII (15.4%) levels. Of the 38 individuals receiving pyrimethamine-sulfadoxine, 13 (34.2%) showed sensitive or RI (delayed) responses, and 25 (65.%) showed resistance at RI (26.3%), RII (36.8%) and RIII (2.6%) levels. Both chloroquine and pyrimethamine-sulfadoxine reduced parasite counts by at least 75% in the majority of the patients within 2 d of treatment. A greater proportion of children with malnutrition showed a higher mean geometric parasite density and slower parasite clearance in vivo than those without malnutrition. Moreover, the frequency and degree of resistance were more pronounced in children with malnutrition. Moreover, the frequency and degree of resistance were more pronounced in children with malnutrition. The results suggest the existence of resistance to chloroquine and pyrimethamine-sulfadoxine. However, the drugs are still effective in significantly reducing parasitaemia and they can still be used as drugs of first and second choice in the region, even in the face of some degree of resistance.
目前认为，恶性疟原虫对现有抗疟药物的耐药性正在撒哈拉以南非洲地区逐渐蔓延。在本研究中，我们测定了居住在扎伊尔戈马的基本巴难民营中的卢旺达患者体内恶性疟原虫对氯喹和乙胺嘧啶 - 磺胺多辛的敏感性。在39例接受氯喹治疗的病例中，只有8例（20.5%）显示敏感或RI（延迟）反应，31例（79.5%）在RI（30.8%）、RII（33.3%）和RIII（15.4%）水平表现出耐药性。在38例接受乙胺嘧啶 - 磺胺多辛治疗的个体中，13例（34.2%）显示敏感或RI（延迟）反应，25例（65.%）在RI（26.3%）、RII（36.8%）和RIII（2.6%）水平表现出耐药性。在大多数患者中，氯喹和乙胺嘧啶 - 磺胺多辛在治疗后2天内均使寄生虫计数至少降低了75%。与无营养不良的儿童相比，营养不良的儿童体内平均几何寄生虫密度更高，寄生虫清除速度更慢。此外，营养不良儿童的耐药频率和程度更为明显。结果表明存在对氯喹和乙胺嘧啶 - 磺胺多辛的耐药性。然而，这些药物在显著降低寄生虫血症方面仍然有效，即使面对一定程度的耐药性，它们在该地区仍可作为首选和次选药物使用。
