Evidence of an increased incidence of day 3 parasitaemia in
Suriname: an indicator of the emerging resistance of Plasmodium
falciparum to artemether |
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Authors: | Stephen GS Vreden Jeetendra K Jitan Rakesh D Bansie Malti R Adhin |
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Institution: | 1.Foundation for Scientific Research Suriname , Paramaribo , Suriname;2.Ministry of Health , Paramaribo , Suriname;3.Department of Internal Medicine , Academic Hospital Paramaribo , Paramaribo , Suriname;4.Department of Biochemistry , Anton de Kom University of Suriname , Paramaribo , Suriname |
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Abstract: | The emerging resistance to artemisinin derivatives that has been reported in
South-East Asia led us to assess the efficacy of artemether-lumefantrine as the first
line therapy for uncomplicated Plasmodium falciparum infections in
Suriname. This drug assessment was performed according to the recommendations of the
World Health Organization in 2011. The decreasing number of malaria cases in
Suriname, which are currently limited to migrating populations and gold miners,
precludes any conclusions on artemether efficacy because adequate numbers of patients
with 28-day follow-up data are difficult to obtain. Therefore, a comparison of day 3
parasitaemia in a 2011 study and in a 2005/2006 study was used to detect the
emergence of resistance to artemether. The prevalence of day 3 parasitaemia was
assessed in a study in 2011 and was compared to that in a study in 2005/2006. The
same protocol was used in both studies and artemether-lumefantrine was the study
drug. Of 48 evaluable patients in 2011, 15 (31%) still had parasitaemia on day 3
compared to one (2%) out of 45 evaluable patients in 2005/2006. Overall, 11 evaluable
patients in the 2011 study who were followed up until day 28 had negative slides and
similar findings were obtained in all 38 evaluable patients in the 2005/2006 study.
The significantly increased incidence of parasite persistence on day 3 may be an
indication of emerging resistance to artemether. |
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Keywords: | artemether artemisinin resistance Plasmodium falciparum day 3 parasitaemia Suriname |
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