Zusammenfassung
Die in vitro Studie hatte das Ziel, die Sensibilität von Plasmodium vivax gegenüber Chloroquin und Artemisinin zu überwachen und jene gegenüber Mefloquin erstmals zu ermitteln. Die Untersuchungen wurden 2004 an den Malariakliniken von Mae Sot, Chedi Ko und Mae Ka Sa im Distrikt von Mae Sot, Provinz Tak im Nordwesten Thailands nahe der Grenze zu Myanmar durchgeführt. Die in vitro Prüfungen folgten der Methode von Tasanor. Insgesamt 45 Parasitenisolate ergaben gültige in vitro Tests. Die mittleren EC50 und EC90 Werte für Chloroquin lagen bei 120,9 nM und 655,7 nM, die GMCOC betrug 1699,7 nM. Der Vergleich mit Daten aus den Jahren 1998 und 1999 zeigte einen signifikanten Rückgang der Sensibilität gegenüber Chloroquin. Allerdings wiesen parallele Studien auf weiterhin volle klinisch-parasitologische Wirksamkeit von Chloroquin hin. Für Mefloquin lagen die EC50 und EC90 Werte bei 131,6 nM und 972,6 nM, die GMCOC betrug 1987,0 nM. Mit Artemisinin wurden EC50 und EC90 Werte von 8,7 nM und 105,2 nM und ein GMCOC-Wert von 310,5 nM beobachtet. Im Vergleich zu 2002 zeigte die Artemisininempfindlichkeit von P. vivax eine geringfügige, unter der Signifikanzgrenze liegende Steigerung.
Summary
The in vitro study had the objectives of monitoring the sensitivity of Plasmodium vivax to chloroquine and artemisinin, and to assess its baseline sensitivity to mefloquine in northwestern Thailand in an area near the border to Myanmar. The investigations were carried out in 2004 at the malaria clinics of Mae Sot, Chedi Ko and Mae Ka Sa, all in the district of Mae Sot, Province of Tak. The in vitro tests followed the method of Tasanor. Successful tests were obtained with 45 fresh isolates of P. vivax. The EC50 and EC90 values for chloroquine were 120.9 nM and 655.7 nM, respectively, the GMCOC was 1699.7 nM. There was a significant decrease of the chloroquine sensitivity since 1998/1999. However, results of parallel investigations continue to indicate clinical-parasitological sensitivity to chloroquine. With mefloquine the EC50 and EC90 the (baseline) values were 131.6 nM and 972.6 nM, respectively, the GMCOC was 1987.0 nM. For artemisinin the EC50 and EC90 values were 8.7 nM and 105.2 nM, respectively, the GMCOC was 310.5 nM. As compared to 2002, the sensitivity of P. vivax to artemisinin has shown a slight but not significant increase.
References
Wernsdorfer G, Wernsdorfer WH (2003) Malaria at the turn from the 2nd to the 3rd millennium. Wien Klin Wochenschr 115 [Suppl 3]: 2–9
Wernsdorfer G, Wernsdorfer WH (1988) Social and economic aspects of malaria and its control. In: Wernsdorfer WH, McGregor IA (eds) Malaria. Principles and practice of malariology. Churchill Livingstone, Edinburgh, pp 1421–1471
Miller LH (1988) Genetically determined human resistance factors. In: Wernsdorfer WH, McGregor IA (eds) Malaria. Principles and practice of malariology. Churchill Livingstone, Edinburgh, pp 487–500
Krotoski WA, Collins WE, Bray RS, Garnham PCC, Cogswell FB, Gwadz R, et al (1982) Demonstration of hypnozoites in sporozoite-transmitted Plasmodium vivax infection. Am J Trop Med Hyg 31: 1291–1293
Wernsdorfer WH (1988) Transfusion malaria and other forms of induced malaria. In: Wernsdorfer WH, McGregor IA (eds) Malaria. Principles and practice of malariology. Churchill Livingstone, Edinburgh, pp 903–912
Macdonald G (1953) Epidemiological basis of malaria control. Bull World Health Org 15: 613–626
World Health Organization (2001) The use of antimalarial drugs. Report of a WHO Informal Consultation. Document WHO/CDS/RBM/2001.33. WHO, Geneva
Schuurkamp GJ, Spicer PE, Kereu RK, Bulungol PK (1989) A mixed infection of vivax and falciparum malaria apparently resistant to 4-aminoquinoline: a case report. Trans R S Trop Med Hyg 83: 607–608
Rieckmann KH, Davis DR, Halton DC (1989) Plasmodium vivax resistance to chloroquine? Lancet 2: 1183–1184
Collignon P (1991) Chloroquine resistance in Plasmodium vivax. J Infect Dis 164: 222–223
Murphy GS, Purnomo HB, Andersen EM, Bangs MJ, Mount DL, Gorden J, et al (1993) Vivax malaria resistant to treatment and prophylaxis with chloroquine. Lancet 341: 96–100
Dua VK, Kar PK, Sharma VP (1992) Chloroquine resistant Plasmodium vivax in India. Trop Med Int Health 1: 816–819
Malar-Than, Myat-Phone-Kyaw, Aye-Yu-Soe, Khaing-Khaing, Ma-Sabai, Myint-Oo (1995) Development of resistance to chloroquine by Plasmodium vivax in Myanmar. Trans R Soc Trop Med Hyg 89: 307–308
World Health Organization (2002) Monitoring antimalarial drug resistance. Report of a WHO Consultation. Document WHO/CDS/CSR/EPH/2002.17. WHO, Geneva
Tasanor O, Noedl H, Na-Bangchang K, Congpuong K, Sirichaisinthop J, Wernsdorfer WH (2002) An in vitro system for assessing the sensitivity of Plasmodium vivax to chloroquine. Acta Tropica 83: 49–61
Congpuong K, Na-Bangchang K, Thimasarn K, Tasanor U, Wernsdorfer WH (2002) Sensitivity of Plasmodium vivax to chloroquine in Sa Kaeo Province, Thailand. Acta Tropica 83: 117–121
Pirker-Krassnig DK, Wernsdorfer G, Sirichaisinthop J, Rojanawatsirivet C, Kollaritsch H, Wernsdorfer WH (2004) Comparative study on the in vitro activity of lumefantrine and desbutyl-benflumetol in fresh isolates of Plasmodium vivax from Thailand. Wien Klin Wochenschr 116 [Suppl 4]: 47–52
Litchfield JT jr, Wilcoxon F (1949) A simplified method of evaluating dose-effect experiments. J Pharm Exp Ther 96: 99–113
Wernsdorfer WH, Wernsdorfer MG (1995) The evaluation of in vitro tests for the assessment of drug response in Plasmodium falciparum. Mitt Österr Ges Tropenmed Parasitol 17: 221–228
Tasanor O, Ruengweerayut R, Sirichaisinthop J, Congpuong K, Wernsdorfer WH, Na-Bangchang K (2006) Clinical-parasitological response and in-vitro sensitivity of Plasmodium vivax to chloroquine and quinine on the western border of Thailand. Trans R Soc Trop Med Hyg 100: 410–418
Wongsrichanalai C, Pickard AL, Wernsdorfer WH, Meshnick SR (2002) Epidemiology of drug-resistant malaria. Lancet (Infect Dis) 2: 209–218
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Woitsch, B., Wernsdorfer, G., Congpuong, K. et al. Susceptibility to chloroquine, mefloquine and artemisinin of Plasmodium vivax in northwestern Thailand. Wien Klin Wochenschr 119 (Suppl 3), 76–82 (2007). https://doi.org/10.1007/s00508-007-0872-6
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DOI: https://doi.org/10.1007/s00508-007-0872-6