Journal Article

Reemergence of Chloroquine-Sensitive Plasmodium falciparum Malaria after Cessation of Chloroquine Use in Malawi

James G Kublin, Joseph F Cortese, Eric Mbindo Njunju, Rabia A G. Mukadam, Jack J Wirima, Peter N Kazembe, Abdoulaye A Djimdé, Bourema Kouriba, Terrie E Taylor and Christopher V Plowe

in The Journal of Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 187, issue 12, pages 1870-1875
Published in print June 2003 | ISSN: 0022-1899
Published online June 2003 | e-ISSN: 1537-6613 | DOI: https://dx.doi.org/10.1086/375419
Reemergence of Chloroquine-Sensitive Plasmodium falciparum Malaria after Cessation of Chloroquine Use in Malawi

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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

Journal Article.  4365 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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