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Cited by 193Malaria Research and ControlPhytochemical compounds biological activitiesPharmaceutical Quality and Counterfeiting

Plasmodium falciparum antimalarial drug susceptibility on the north- western border of Thailand during five years of extensive use of artesunate-mefloquine.

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Brockman, A., Price, R.N., van Vugt, M., Heppner, D.G., Walsh, D., Sookto, P., Wimonwattrawatee, T., Looareesuwan, S. +2 more·2000·Transactions of the Royal Society of Tropical Medicine and Hygiene
DOI 10.1016/s0035-9203(00)90080-4PMC PMC4340572
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Abstract

Following a marked decline in the efficacy in vivo of mefloquine between 1990 and 1994, a combination of artesunate (4 mg/kg/d for 3 d) and mefloquine (25 mg/kg) has been used as first line treatment of uncomplicated falciparum malaria in camps for displaced persons located along the north-western border of Thailand. Antimalarial drug susceptibility of fresh isolates of Plasmodium falciparum from this population was evaluated using a radioisotope microdilution assay between 1995 and 1999. In total, 268 isolates were collected, of which 189 were from primary infections and 79 from recrudescent infections. The geometric mean 50% inhibitory concentration (IC50) values from primary infections were: dihydroartemisinin 1.2 ng/mL, artesunate 1.6 ng/mL, artemether 4.8 ng/mL, atovaquone 0.4 ng/mL, lumefantrine 32 ng/mL, chloroquine 149 ng/mL, quinine 354 ng/mL, mefloquine 27 ng/mL and halofantrine 4.1 ng/mL. A significant positive correlation was found between the susceptibility in vitro to artesunate and quinine (r = 0.43, P < 0.001), mefloquine (r = 0.46, P < 0.001), and halofantrine (r = 0.51, P < 0.001). These levels of resistance in vitro are among the highest reported and confirm continuing high level multidrug resistance in this area. Despite intensive use of the combination between 1995 and 1999 there has been a significant improvement in mefloquine sensitivity (P < 0.001) and artesunate sensitivity (P < 0.001). This supports observations in vivo that the combination of artesunate and mefloquine has reversed the previous decline in mefloquine sensitivity.

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  • There are no reliable malaria preventative measures for pregnant women in this area, and treatment options are limited because of a high prevalence of multidrug resistant P. falciparum and because primaquine for radical cure of vivax malaria is contraindicated in pregnancy.

    “There are no reliable malaria preventative measures [17]–[19] for pregnant women and treatment options are limited because of a high prevalence of multidrug resistant P. falciparum and because primaquine for radical cure of vivax malaria is contraindicated in pregnancy. [20]”

    From Effect of Early Detection and Treatment on Malaria Related Maternal Mortality on the North-Western Border of Thailand 1986-2010 (2012) · cites this paper as [20]

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Authors
Brockman, A., Price, R. N., van Vugt, M., Heppner, D. G., Walsh, D., Sookto, P., Wimonwattrawatee, T., Looareesuwan, S., White, N. J., & Nosten, F.
Affiliations
  • Mahidol University (TH)
  • John Radcliffe Hospital (GB)
  • Armed Forces Research Institute of Medical Science (TH)
ORCID
Venue
Transactions of the Royal Society of Tropical Medicine and Hygiene
Publisher
Oxford University Press (OUP)
Published
2000-09
Volume
94
Issue
5
Pages
537-544
ISSN
0035-9203 (ISSN-L)
DOI
10.1016/s0035-9203(00)90080-4
PMC
PMC4340572
OpenAlex
W2132714058
Cited by
185
References
28
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 5 · 2013: 7 · 2012: 7
FWCI
11.33
Type
journal article
Language
en
Open access
Locations
  • Transactions of the Royal Society of Tropical Medicine and Hygiene (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Funders
  • Wellcome Trust (074637)
  • University of Oxford
  • Mahidol University
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Phytochemical compounds biological activities
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pharmaceutical Quality and Counterfeiting
Keywords
Plasmodium falciparum, antimalarial drug susceptibility, mefloquine resistance, multidrug resistance, artesunate, quinine, halofantrine, atovaquone, lumefantrine, dihydroartemisinin, chloroquine, displaced persons camps, recrudescent infection
MeSH terms
Artesunate, Adolescent, Adult, Aged, Animals, Antimalarials, Child, Child, Preschool, Dose-Response Relationship, Drug, Drug Combinations, Female, Humans, Infant, Lethal Dose 50, Male, Microbial Sensitivity Tests, Middle Aged, Plasmodium falciparum, Quality Control, Sesquiterpenes, Thailand, Mefloquine, Confounding Factors, Epidemiologic, Malaria, Falciparum, Artemisinins

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