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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Emergence of plasmodium vivax resistance to chloroquine in French guiana
Antimicrobial Agents and Chemotherapy, Volume 63, No. 11, Article e02116-18, Year 2019
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Description
In South America, Plasmodium vivax resistance to chloroquine was recently reported in Brazil and Bolivia. The objective of this study was to collect data on chloroquine resistance in French Guiana by associating a retrospective evaluation of therapeutic efficacy with an analysis of recurrent parasitemia from any patients. Patients with P. vivax infection, confirmed by microscopy and a body temperature of >37.5°C, were retrospectively identified at Cayenne Hospital between 2009 and 2015. Follow-up and treatment responses were performed according to the World Health Organization protocol. Parasite resistance was confirmed after dosage of a plasma concentration of chloroquine and microsatellite characterization. The pvmdr1 and pvcrt-o genes were analyzed for sequence and gene copy number variation. Among the 172 patients followed for 28 days, 164 presented adequate clinical and parasitological responses. Eight cases of treatment failures were identified (4.7%; n = 8/172), all after 14 days. The therapeutic efficacy of chloroquine was estimated at 95.3% (95% confidence interval [CI], 92.5 to 98.1%; n = 164/172). Among the eight failures, five were characterized: two cases were true P. vivax chloroquine resistance (1.2%; 95% CI, 0 to 2.6%; n = 2/172), and three cases were found with subtherapeutic concentrations of chloroquine. No particular polymorphism in the Plasmodium vivax pvmdr1 and pvcrt-o genes was identified in the resistant parasites. This identified level of resistance of P. vivax to chloroquine in French Guiana does not require a change in therapeutic recommendations. However, primaquine should be administered more frequently to limit the spread of resistance, and there is still a need for a reliable molecular marker to facilitate the monitoring of P. vivax resistance to chloroquine. © 2019 Musset et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.
Authors & Co-Authors
Musset, Lise
French Guiana, Cayenne
Institut Pasteur de la Guyane
Blanchet, Denis
French Guiana, Cayenne
Centre Hospitalier Andree Rosemon
Houzé, Pascal
France, Paris
Hôpital Saint-louis
Volney, Béatrice
French Guiana, Cayenne
Institut Pasteur de la Guyane
Epelboin, Loïc
French Guiana, Cayenne
Centre Hospitalier Andree Rosemon
Pelleau, Stéphane
French Guiana, Cayenne
Institut Pasteur de la Guyane
Ringwald, Pascal
Switzerland, Geneva
Organisation Mondiale de la Santé
Legrand, Eric
France, Paris
Institut Pasteur, Paris
Demar, Magalie Pierre
French Guiana, Cayenne
Centre Hospitalier Andree Rosemon
Djossou, Félix
French Guiana, Cayenne
Centre Hospitalier Andree Rosemon
Statistics
Citations: 11
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1128/AAC.02116-18
ISSN:
00664804
Research Areas
Genetics And Genomics
Health System And Policy
Study Design
Cohort Study