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Chloroquine resistant falciparum malaria in Mutare District, eastern Zimbabwe
A I Mahomva1, D E Peterson, L Rakata
1Ministry of Health and Child Welfare, Mutare, Zimbabwe.
Objective:
From 1992 to 1994 malaria incidence and mortality increased in Manicaland province despite an intensified malaria control programme. This was perhaps due to chloroquine resistance. The magnitude of chloroquine resistance in unstable malaria transmission areas of Zimbabwe is unknown.
Design:
A modified seven day prospective World Health Organization in vivo test for chloroquine resistance was carried out from February 27 to April 13, 1995.
Setting:
Two Mutare district primary health care centres, in Manicaland Province.
Subjects:
Thirty three patients were enrolled and 30 completed follow up.
Main Outcome Measures:
Cases were classified according to WHO classification for chloroquine resistances as S/R1, R2 or R3.
Results:
The median age of the 30 cases was 12 years with a range of five to 60 years. Twenty cases (67 pc were S/R1, three (10pc) were R2 and seven (23 pc) were R3. By day 3 of chloroquine treatment there was a more than 50pc reduction in malaria related symptoms in all the three classifications.
Conclusion:
High level resistance (R2 and R3) of 33pc was demonstrated. Early symptom response did not give an indication of resistance. We recommend a re-assessment of the provincial malaria treatment policy with consideration of introduction of a second line antimalarial drug at the health centre level.