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Chloroquine-resistant malaria in Burma.

Aung-Than-Batu, R Htun Nyun, N Hlaing

The Journal of Tropical Medicine and Hygiene

|August 1, 1975

Summary

Chloroquine-resistant malaria (Plasmodium falciparum) is prevalent, showing resistance to multiple drugs. Quinine and specific combination therapies remain effective for treatment and prophylaxis.

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Area of Science:

Tropical Medicine
Infectious Diseases
Pharmacology

Background:

Malaria remains a significant global health challenge, with drug resistance complicating treatment strategies.
The emergence of chloroquine-resistant Plasmodium falciparum necessitates ongoing surveillance and the identification of effective alternative therapies.

Purpose of the Study:

To assess the prevalence of chloroquine resistance in Plasmodium falciparum malaria.
To evaluate the efficacy of various antimalarial drugs and drug combinations against resistant strains.

Main Methods:

Field trials conducted near Rangoon following WHO guidelines.
Monitoring of asexual Plasmodium falciparum forms via peripheral blood smears.
Assessment of drug efficacy through clinical response and measurement of plasma drug levels.

Main Results:

High rates of chloroquine resistance (RI, RII, RIII) detected in 105 patients.
Resistant strains showed cross-resistance to pyrimethamine and sulphamethoxypyridazine monotherapies and certain combinations.
Sensitivity was observed with quinine sulphate and specific combination therapies including trimethoprim/sulphalene and pyrimethamine/sulphamethoxine.
Weekly pyrimethamine/dapsone demonstrated effective chemoprophylaxis.

Conclusions:

Chloroquine resistance in Plasmodium falciparum is a significant issue in the studied region.
Quinine and specific combination therapies offer viable treatment options.
Pyrimethamine/dapsone combination is effective for malaria chemoprophylaxis.

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