[e-med] Paludisme : retour de sensibilité à la chloroquine

[Serge Barbereau <remed@remed.org>]

E-MED: Paludisme : retour de sensibilité à la chloroquine
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Une étude menée au Malawi montre que Plasmodium falciparum est redevenu
sensible à la chloroquine après une interruption d'utilisation de cette
molécule pendant près de dix ans. Son administration pendant trois jours à
63 personnes asymptomatiques atteintes de paludisme a révélé une efficacité
de la molécule de 100 % .

"Journal of infectious diseases."

Serge Barbereau
Réseau Médicaments et Développement
35 rue Daviel
75 013 Paris
tel 33 1 53 80 20 20
fax 33 1 53 80 20 21
REMED.75013@wanadoo.fr
remed@remed.org


[Mod.: voici le résumé Medline :
Infect Dis. 2003 Jun 15;187(12):1870-5.

Reemergence of chloroquine-sensitive Plasmodium falciparum malaria after 
cessation of chloroquine use in Malawi.

Kublin JG, Cortese JF, Njunju EM, Mukadam RA, Wirima JJ, Kazembe PN, Djimde 
AA, Kouriba B, Taylor TE, Plowe CV.
Malaria Section, Center for Vaccine Development, University of Maryland 
School of Medicine, Baltimore, Maryland, USA.

In 1993, Malawi became the first African country to replace chloroquine 
with sulfadoxine-pyrimethamine nationwide in response to high rates of 
chloroquine-resistant falciparum malaria. To determine whether withdrawal 
of chloroquine can lead to the reemergence of chloroquine sensitivity, the 
prevalence of the pfcrt 76T molecular marker for chloroquine-resistant 
Plasmodium falciparum malaria was retrospectively measured in Blantyre, 
Malawi. The prevalence of the chloroquine-resistant pfcrt genotype 
decreased from 85% in 1992 to 13% in 2000. In 2001, chloroquine cleared 
100% of 63 asymptomatic P. falciparum infections, no isolates were 
resistant to chloroquine in vitro, and no infections with the 
chloroquine-resistant pfcrt genotype were detected. A concerted national 
effort to withdraw chloroquine from use has been followed by a return of 
chloroquine-sensitive falciparum malaria in Malawi. The reintroduction of 
chloroquine, ideally in combination with another antimalarial drug, should 
be considered in areas where chloroquine resistance has declined and safe 
and affordable alternatives remain unavailable.]

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