E-MED: Paludisme : retour de sensibilit� � la chloroquine
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Une �tude men�e au Malawi montre que Plasmodium falciparum est redevenu
sensible � la chloroquine apr�s une interruption d'utilisation de cette
mol�cule pendant pr�s de dix ans. Son administration pendant trois jours �
63 personnes asymptomatiques atteintes de paludisme a r�v�l� une efficacit�
de la mol�cule de 100 % .
"Journal of infectious diseases."
Serge Barbereau
R�seau M�dicaments et D�veloppement
35 rue Daviel
75 013 Paris
tel 33 1 53 80 20 20
fax 33 1 53 80 20 21
REMED.75013@wanadoo.fr
remed@remed.org
[Mod.: voici le r�sum� Medline :
Infect Dis. 2003 Jun 15;187(12):1870-5.
Reemergence of chloroquine-sensitive Plasmodium falciparum malaria after
cessation of chloroquine use in Malawi.
Kublin JG, Cortese JF, Njunju EM, Mukadam RA, Wirima JJ, Kazembe PN, Djimde
AA, Kouriba B, Taylor TE, Plowe CV.
Malaria Section, Center for Vaccine Development, University of Maryland
School of Medicine, Baltimore, Maryland, USA.
In 1993, Malawi became the first African country to replace chloroquine
with sulfadoxine-pyrimethamine nationwide in response to high rates of
chloroquine-resistant falciparum malaria. To determine whether withdrawal
of chloroquine can lead to the reemergence of chloroquine sensitivity, the
prevalence of the pfcrt 76T molecular marker for chloroquine-resistant
Plasmodium falciparum malaria was retrospectively measured in Blantyre,
Malawi. The prevalence of the chloroquine-resistant pfcrt genotype
decreased from 85% in 1992 to 13% in 2000. In 2001, chloroquine cleared
100% of 63 asymptomatic P. falciparum infections, no isolates were
resistant to chloroquine in vitro, and no infections with the
chloroquine-resistant pfcrt genotype were detected. A concerted national
effort to withdraw chloroquine from use has been followed by a return of
chloroquine-sensitive falciparum malaria in Malawi. The reintroduction of
chloroquine, ideally in combination with another antimalarial drug, should
be considered in areas where chloroquine resistance has declined and safe
and affordable alternatives remain unavailable.]
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