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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., White, N.J., Nosten, F.·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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Baseline Epidemiological Study of Malaria and Soil-transmitted Helminthiasis in Thai Rural Communities near the Myanmar Border
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Additional file 1 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595827
Additional file 5 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595839
Additional file 10 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595854
Additional file 8 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595848
Additional file 2 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595830
Additional file 9 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595851
Additional file 3 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595833
Additional file 7 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595845
Additional file 4 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595836
Additional file 6 of Why is Babesia not killed by artemisinin like Plasmodium?
Si, W., Fang, C., Liu, C., Yin, M., Xu, W., Li, Y., Yan, X., Shen, Y., Cao, J., & Sun, J. (2024) · Figshare · doi:10.6084/m9.figshare.26595842
Déploiement d’une nouvelle stratégie de traitement d’une maladie à transmission vectorielle : application au paludisme, analyse des pratiques thérapeutiques, et conséquences sur l’épidémiologie de P. falciparum en Casamance, Sénégal, 1996 - 2009
Vaillant, M. (2010) · doi:10.70675/d305f74bz4077z44dfzb541zf371552b3fae
Conception, synthèse et activité antiplasmodiale de nouveaux composés ferrocéniques
Maguene, G. M. (2011) · theses.fr (ABES) · doi:10.70675/c59b2675zb468z4a56zb3ccz1dc5baffcd20

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: Price, R.N.
White, N.J.
Nosten, F.
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: green
www.ncbi.nlm.nih.gov
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 › Pharmacology, Toxicology and Pharmaceutics › Drug Discovery › 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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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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