no seasonal accumulation of resistant p. falciparum when high-dose chloroquine is used没有季节性的积累使用高剂量时抗恶性疟原虫氯喹.pdfVIP

No Seasonal Accumulation of Resistant P. falciparum when High-Dose Chloroquine Is Used 1,2 2,3,4 2 1,5,6 Johan Ursing *, Poul-Erik Kofoed , Amabelia Rodrigues , Lars Rombo ´ 1 Malaria Research, Department of Infectious Diseases, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden, 2 Projecto de Saude de Bandim, Indepth Network, Bissau, Guinea-Bissau, 3 Department of Paediatrics, Kolding Hospital, Kolding, Denmark, 4 Research Initiative of Health Services, Kolding Hospital, Kolding, Denmark, ¨ 5 Department of Infectious Diseases, Malarsjukhuset, Eskilstuna, Sweden, 6 Center for Clinical Research, Sormland County Council, Eskilstuna, Sweden Abstract Background: Potentially chloroquine resistant P. falciparum, identified by the 76T haplotype in the chloroquine resistance transporter (pfcrt 76T), are highly prevalent throughout Africa. In Guinea-Bissau, normal and double dose chloroquine have respective efficacies of 34% and 78% against P.falciparum with pfcrt 76T and approximately three times the normal dose of chloroquine is routinely taken. Proportions of pfcrt 76T generally increase during high transmission seasons, as P.falciparum with pfcrt 76T commonly survive treatment with normal dose chloroquine. In Guinea-Bissau, there should be no seasonal increase of pfcrt 76T if the high doses of CQ commonly used are effective. Methods and Findings: P. falciparum parasite density, age, sex, the proportion of chloroquine resistance associated haplotypes pfcrt 76T and P. falciparum multidrug resistance gene 1 86Y were assessed in 988