0
ARTICLE |

Failure of Chloroquine Prophylaxis in Plasmodium falciparum From East Africa FREE

Amy L. Gardner, MS; Robert A. Weinstein, MD; Lawrence J. Lincoln, MD
[+] Author Affiliations

Reprint requests to Vector Biology and Control Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 (Ms Gardner).


JAMA. 1981;246(9):979-980. doi:10.1001/jama.1981.03320090041026
Text Size: A A A
Published online

IN 1979, four cases of chloroquineresistant Plasmodium falciparum infections were reported from Kenya and Tanzania.1-4 All four cases were characterized by RI type of resistance5 (RI in vivo resistance indicates that, following a 1.5-g [base] dose of chloroquine, the parasitemia clears within seven days but recrudesces from persisting blood forms within 28 days of initiation of therapy). These cases represent the only documented evidence of chloroquine-resistant falciparum malaria in East Africa. We report evidence of another manifestation of chloroquine resistance in East Africa, the development of falciparum malaria in two persons despite adequate chloroquine prophylaxis.

Report of Cases 

Case 1.—  A 27-year-old white American woman traveled in rural northeast Tanzania from June 15 to July 6, 1980. One week before her departure, she began and reportedly took 500 mg of chloroquine phosphate (300-mg base) weekly. She continued to follow this same regimen after her return to the United

REFERENCES

Fogh S, Jepsen S, Efferson P:  Chloroquineresistant Plasmodium falciparum malaria in Kenya . Trans R Soc Trop Med Hyg 1979;;73:228-229.
Kean BH:  Chloroquine-resistant falciparum malaria from Africa . JAMA 1979;;241:395.
Stille W:  Chloroquine-resistente malaria tropica nach Kenia-Reise . Dtsch Med Wochenschr 1979;;104:954-955.
Campbell CC, Chin W, Collins WE, et al:  Chloroquine-resistant Plasmodium falciparum from East Africa: Cultivation and drug sensitivity of the Tanzanian I/CDC strain from an American tourist . Lancet 1979;;2:1151-1154.
 Chemotherapy of malaria and resistance to antimalarials . WHO Tech Rep Ser , No. (529) , 1973;, pp 30-39.
Staiger M, Nguyen-Dinh P, Churchill F:  Sensitive HPLC analysis for chloroquine in body fluids: Application to studies of drug resistance in Plasmodium falciparum . J Chromatogr , to be published.
Berlinger RW, Earle DP, Taggart JV, et al:  Studies on the chemotherapy of the human malarias: VI. The physiological disposition, antimalarial activity, and toxicity of several derivatives of 4-amino-quinoline . J Clin Invest 1948;; 27:98-107.
Nguyen-Dinh P, Trager W:  Plasmodium falciparum in vitro: Determination of chloroquine sensitivity of three new strains by a modified 48-hour test . Am J Trop Med Hyg 1980;;29:339-342.
Degowin R, Powell RD:  Drug resistance of a strain of Plasmodium falciparum from Malaya . Am J Trop Med Hyg 1965;;14:519-528.
Eppes RB, McNamara JV, Degowin RL, et al:  Chloroquine-resistant Plasmodium falciparum: Protective and hemolytic effects of 4,4′-diaminodiphenylsulfone (DDS) administered daily together with weekly chloroquine and primaquine . Milit Med 1967;;132:163-175.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Fogh S, Jepsen S, Efferson P:  Chloroquineresistant Plasmodium falciparum malaria in Kenya . Trans R Soc Trop Med Hyg 1979;;73:228-229.
Kean BH:  Chloroquine-resistant falciparum malaria from Africa . JAMA 1979;;241:395.
Stille W:  Chloroquine-resistente malaria tropica nach Kenia-Reise . Dtsch Med Wochenschr 1979;;104:954-955.
Campbell CC, Chin W, Collins WE, et al:  Chloroquine-resistant Plasmodium falciparum from East Africa: Cultivation and drug sensitivity of the Tanzanian I/CDC strain from an American tourist . Lancet 1979;;2:1151-1154.
 Chemotherapy of malaria and resistance to antimalarials . WHO Tech Rep Ser , No. (529) , 1973;, pp 30-39.
Staiger M, Nguyen-Dinh P, Churchill F:  Sensitive HPLC analysis for chloroquine in body fluids: Application to studies of drug resistance in Plasmodium falciparum . J Chromatogr , to be published.
Berlinger RW, Earle DP, Taggart JV, et al:  Studies on the chemotherapy of the human malarias: VI. The physiological disposition, antimalarial activity, and toxicity of several derivatives of 4-amino-quinoline . J Clin Invest 1948;; 27:98-107.
Nguyen-Dinh P, Trager W:  Plasmodium falciparum in vitro: Determination of chloroquine sensitivity of three new strains by a modified 48-hour test . Am J Trop Med Hyg 1980;;29:339-342.
Degowin R, Powell RD:  Drug resistance of a strain of Plasmodium falciparum from Malaya . Am J Trop Med Hyg 1965;;14:519-528.
Eppes RB, McNamara JV, Degowin RL, et al:  Chloroquine-resistant Plasmodium falciparum: Protective and hemolytic effects of 4,4′-diaminodiphenylsulfone (DDS) administered daily together with weekly chloroquine and primaquine . Milit Med 1967;;132:163-175.
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.