Raharimalala L, Rabarison P, Lepers-Rason M D, Lepers J P, Ramambanirina L, Rason M A, Jambou R, Roux J
Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Sante. 1995 Nov-Dec;5(6):389-92.
In Madagascar, Plasmodium falciparum resistance to chloroquine was clinically suspected in 1975 by Goasguen and demonstrated in 1981 by Arronson et al. Since then, many studies were conducted throughout the island, in the North, South, East and West, on the high Plateau and on the coasts. Two methods were used, including an in vivo method similar to the therapeutic standard protocol of the WHO, and an in vitro method employing the semi-microtest of Le Bras and Deloron. From 1982 to 1986, the 291 in vivo tests performed showed that 20% of the strains were of the types R1 or R2 (SR1 included). From 1987 to 1994, of the 621 in vivo tests performed, 369 (59.4%) of the cases responded to treatment. The deterioration of the situation observed in 1988 (Lepers et al.) seemed to be stabilized (Ringwald et al.). No strain of the type R3 was found. In conclusion, we report the absence of strain type R3 and also the clinical efficacy of chloroquine. The action of chloroquine was spectacular on the fevers and there was remarkable reduction of the parasitaemia. Thus, for treating outbreaks of simple malaria in Madagascar, chloroquine remains the best choice if it is administered at an efficacious dose.
1975年，戈阿斯根在马达加斯加临床上怀疑恶性疟原虫对氯喹产生了抗药性，1981年阿伦森等人证实了这一点。从那时起，在全岛各地，包括北部、南部、东部和西部，在高原地区和沿海地区开展了许多研究。使用了两种方法，一种是类似于世卫组织治疗标准方案的体内方法，另一种是采用勒布拉斯和德洛龙半微量试验的体外方法。1982年至1986年进行的291次体内试验表明，20%的菌株属于R1或R2型（包括SR1）。1987年至1994年，在进行的621次体内试验中，369例（59.4%）对治疗有反应。1988年观察到的病情恶化（莱佩斯等人）似乎得到了稳定（林瓦尔德等人）。未发现R3型菌株。总之，我们报告未发现R3型菌株以及氯喹的临床疗效。氯喹对发热的作用显著，寄生虫血症明显减少。因此，对于治疗马达加斯加单纯性疟疾的暴发，如果以有效剂量给药，氯喹仍然是最佳选择。
