In Vitro Monitoring of Plasmodium falciparum Drug Resistance in French Guiana: a Synopsis of Continuous Assessment from 1994 to 2005
- 1 January 2008
- journal article
- research article
- Published by American Society for Microbiology in Antimicrobial Agents and Chemotherapy
- Vol. 52 (1), 288-298
- https://doi.org/10.1128/aac.00263-07
Abstract
Implemented as one arm of the malaria control program in French Guiana in the early 1990s, our laboratory has since established in vitro profiles for parasite drug susceptibility to a panel of eight antimalarials for more than 1,000 Plasmodium falciparum isolates from infected patients. The quinine-doxycycline combination was introduced in 1995 as the first-line drug treatment against uncomplicated P. falciparum malaria, replacing chloroquine, and the first-line drug combination was changed to the artemether-lumefantrine combination in 2002. Resistance to chloroquine declined 5 years after it was dropped in 1995 as the first-line drug, but unlike similar situations in Africa, there was a rapid halt to this decline. Doxycycline susceptibility substantially decreased from 2002 to 2005, suggesting parasite selection under quinine-doxycycline drug pressure. Susceptibility to mefloquine decreased from 1997 onward. Throughout the period from 1994 to 2005, most isolates were sensitive in vitro to quinine, amodiaquine, and atovaquone. Susceptibility to amodiaquine was strongly correlated with that to chloroquine and to a lesser extent with that to mefloquine and halofantrine. Susceptibilities to mefloquine and to halofantrine were also strongly correlated. There were two alerts issued for in vitro artemether resistance in the period from 2002 to 2003 and again in 2005, both of which could be associated with the presence of an S769N polymorphism in the sarcoplasmic/endoplasmic reticulum calcium ATPase (SERCA)-type P. falciparum ATPase6 (Pf ATPase6 ) gene. Analysis of susceptibility to lumefantrine, conducted for the first time in 2005, indicates an alarming rate of elevated 50% inhibitory concentrations. In vitro monitoring of parasite drug susceptibility should be pursued to further document the consequences of specific drug policies on the local parasite population and, in particular, to establish profiles of susceptibility to individual components of drug combinations to provide early warning signs of emerging parasite resistance.Keywords
This publication has 33 references indexed in Scilit:
- Reemergence of Chloroquine‐SensitivePlasmodium falciparumMalaria after Cessation of Chloroquine Use in MalawiThe Journal of Infectious Diseases, 2003
- RECOVERY OF CHLOROQUINE SENSITIVITY AND LOW PREVALENCE OF THE PLASMODIUM FALCIPARUM CHLOROQUINE RESISTANCE TRANSPORTER GENE MUTATION K76T FOLLOWING THE DISCONTINUANCE OF CHLOROQUINE USE IN MALAWIThe American Journal of Tropical Medicine and Hygiene, 2003
- In vitro activity of artemether against African isolates (Senegal) of Plasmodium falciparum in comparison with standard antimalarial drugs.The American Journal of Tropical Medicine and Hygiene, 1998
- In Vitro Responses of Plasmodium falciparum Isolates to Five Antimalaria Drugs in French Guiana during 1994 and 1995Memórias do Instituto Oswaldo Cruz, 1997
- Changes in the resistance of Plasmodium falciparum to chloroquine in Hainan, China.1995
- Fast emergence of Plasmodium falciparum resistance to halofantrineThe Lancet, 1993
- Emergence of mefloquine-resistant malaria in Africa without drug pressureThe Lancet, 1990
- [Epidemiology of malaria in French Guiana].1990
- [Malaria in Guiana. I. General status of the endemic].1989
- [In vitro activity of various antimalarials (chloroquine, amodiaquine, quinine and mefloquine) against 32 isolates of Plasmodium falciparum in French Guiana].1988