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Chloroquine resistant malaria in children

I A Memon¹, N Kanth, G Murtaza

¹Department of Paediatrics, Dow Medical College, Mirpurkhas, Sindh.

JPMA. the Journal of the Pakistan Medical Association

|October 23, 1998

Summary

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Malaria treatment effectiveness varies due to drug resistance. Plasmodium falciparum malaria showed significant chloroquine resistance, necessitating alternative antimalarial therapies for better patient outcomes.

Area of Science:

Tropical Medicine
Infectious Diseases
Pharmacology

Background:

Malaria poses a significant global health challenge, particularly in children, with evolving drug resistance impacting treatment efficacy.
Global generalizations regarding malaria chemotherapy are no longer reliable due to changing parasite susceptibility.

Purpose of the Study:

To investigate the prevalence of malaria species and chloroquine resistance in Mirpurkhas, Sindh.
To evaluate the effectiveness of alternative antimalarial drugs in cases of chloroquine non-response.

Main Methods:

Slide-documented malaria cases were analyzed over a 16-month period at District Hospital, Mirpurkhas.
Parasite species (Plasmodium falciparum, Plasmodium vivax) and response to chloroquine were recorded.
Non-responders were treated with halofantrine or sulfadoxine-pyrimethamine; outcomes were observed.

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Main Results:

Plasmodium falciparum was the dominant species (65%), followed by Plasmodium vivax (33%).
Approximately 81% of patients responded to chloroquine, with 19% showing non-response.
Chloroquine non-responders were successfully treated with halofantrine or sulfadoxine-pyrimethamine.

Conclusions:

Plasmodium falciparum resistance to chloroquine is a significant concern, especially in severe malaria cases.
Parenteral quinine is recommended for severe or life-threatening Plasmodium falciparum malaria.
Rational drug use, reserving alternatives for non-responders, is crucial for effective malaria management.