| Title | In vitro monitoring of Plasmodium falciparum drug resistance in French Guiana: a synopsis of continuous assessment over the years 1994-2005. | | Author(s) | Legrand E, Volney B, Meynard JB, Mercereau-Puijalon O, Esterre P | | Institution | Reference Centre for Plasmodium Chemoresistance in French Guiana and West Indies (CNRCP), Institut Pasteur de la Guyane, Cayenne, French Guiana; Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana; Parasite Molecular Immunology, CNRS URA 2581, Institut Pasteur, Paris, France. | | Source | Antimicrob Agents Chemother 2007 Oct 22. | | Abstract | Implemented as one arm of the malaria control programme in French Guiana in the early 1990's, our laboratory has established in vitro drug susceptibility profiles to a panel of eight antimalarials for more than a thousand Plasmodium falciparum patient isolates. The quinine-doxycycline combination was introduced in 1995 as first- line treatment against uncomplicated P. falciparum malaria to replace chloroquine, and was changed for the artemether-lumefantrine combination in 2002. Resistance to chloroquine declined five years after it was dropped in 1995 as the first- line drug, but unlike similar situations in Africa, there was a rapid halt to this decline. Doxycycline susceptibility substantially decreased in 2002-5, suggesting parasite selection under quinine-doxycycline drug pressure. Susceptibility to mefloquine decreased from 1997 onwards. Throughout the 1994-2005 period, most isolates were sensitive in vitro to quinine, amodiaquine and atovaquone. Susceptibility to amodiaquine was strongly correlated with chloroquine, and to a lesser extent with mefloquine and halofantrine. Susceptibility to mefloquine and halofantrine was also strongly correlated. There were two alerts for in vitro artemether resistance, in 2002-3 and again in 2005, both of which could be associated with the presence of a 769N polymorphism in the SERCA-type PfATPase6 gene. Analysis of susceptibility to lumefantrine, conducted for the first time in 2005, indicates an alarming rate of elevated IC50. In vitro monitoring of parasite drug susceptibility should be pursued to further document the consequences of specific drug policies on the local parasite population, in particular for each individual component of drug combinations so as to provide early warning signs of emerging parasite resistance. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 17954693 |
|
