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Drug-resistant Plasmodium falciparum infection in immigrants and non-immune travellers
1Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait. iqbal@hsc.kuniv.edu.kw
Objective:
To detect the incidence of drug-resistant Plasmodium falciparum malaria infection in immigrants and travellers in non-endemic Kuwait.
Methods:
Over a period of 3 years, July 1995 to September 1998, 1352 malaria patients were enrolled in the study. Of these, 1293 were immigrants from countries where malaria is endemic and 59 were non-immune travellers with a recent history of travel to these countries. The in vitro drug sensitivity was determined in 892 patients.
Results:
In all, 892 of 1352 (66.0%) P. falciparum isolates were successfully cultured in vitro for drug sensitivity and 419 (47.0%) isolates showed in vitro resistance to chloroquine or mefloquine. Fifty-six (13.4%) isolates were resistant to both drugs. Chloroquine resistance was observed in > 70% of the isolates from Africa and India followed by Pakistan (39.9%) and Bangladesh (35.9%). The resistance to mefloquine ranged from 26.2% in isolates from Sri Lanka to 47.5% in isolates from African countries.
Conclusion:
The study highlights the important trend in drug resistance in P. falciparum malaria in immigrants from south-east Asian and African countries.