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© Artur Scherf
Scanning Electron Microscopy of Red Blood Cell infected by Plasmodium falciparum.
Publication : Scandinavian journal of infectious diseases

History and current status of Plasmodium falciparum antimalarial drug resistance in Madagascar

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Scandinavian journal of infectious diseases - 01 Jan 2010

Andriantsoanirina V, Ménard D, Tuseo L, Durand R

Link to Pubmed [PMID] – 19883158

Scand. J. Infect. Dis. 2010;42(1):22-32

Malaria remains a major health problem in Madagascar. Over past decades, the burden of malarial disease has fluctuated over time, partly in line with the successes and failures of antimalarial policy. In the 1950s and 1960s, a sharp decline in malaria transmission was observed in the central highlands due to indoor spraying with DDT and to the massive use of chloroquine by the population. Following this, the discontinuation of the ‘nivaquinization’ policy was followed by devastating outbreaks in the central highlands in the 1980s. Currently, the rate of in vitro chloroquine-resistant Plasmodium falciparum isolates does not exceed 5%. This figure appears disconnected from the high level of clinical treatment failure (near 40%). pfcrt mutant isolates are found in less than 1% of isolates on the Island. Conversely, pfmdr1 mutant isolates are found in more than 60% of isolates and may be responsible for the bulk of resistance to chloroquine in Madagascar. Other antimalarials remain generally effective in Madagascar. Recent clinical and in vitro data support the complete efficacy of the combination artesunate-amodiaquine in Madagascar. As such, this artemisinin combination therapy should play a central role in the control and possible elimination of P. falciparum malaria in Madagascar

https://www.ncbi.nlm.nih.gov/pubmed/19883158