Untersuchungen zur in vitro arzneimittelresistenz bei malaria tropica in Bangladesch

Translated title of the contribution: In vitro antimalarial drug resistance in Southeastern Bangladesh

Bernhard Attlmayr, Kamala Thriemer, Rashidul Haque, Yukiko Wagatsuma, Mohammed Abdus Salam, Selim Akhter, Mark Fukuda, Kurt Schaecher, Robert Scott Miller, Harald Noedl

Research output: Contribution to journalArticlepeer-review

Abstract

Particularly in Southeast Asia drug resistance has become a major constraint in the treatment of falciparum malaria. So far relatively little is known about the current status of drug resistance in Bangladesh, The aim of this study was therefore to determine the in vitro drug susceptibility of Plasmodium falciparum in southeastern Bangladesh. In the HRP2 in vitro drug sensitivity assay the tested isolates demonstrated a relatively high sensitivity to dihydroartemisinine (IC50 = 1.33nM; 95% CI: 1.08-1.63; IC90 = 2.65 nM; 95% CI: 2.13-3.29), mefloquine (IC50 = 11.26 nM, 95% CI: 9.75-13.0; IC90 = 19.55 nM, 95% CI: 15.73-24.29) and quinine (IC50 = 73.24 nM, 95% CI: 65.26-82.21; IC90 = 157.75 nM, (95% CI: 134.16-185.5) thus being significantly more sensitive to mefloquine and quinine than isolates from Thailand. Chloroquine (IC50 = 93.06 nM, 95% CI: 80.38-107.76; IC90 = 214.76 nM, 95% CI: 175.64-262.62) sensitivity was highly compromised with inhibitory concentrations reaching levels comparable to Thailand. Therefore this drug should not be used in the treatment of falciparum malaria in this region. Despite compromised in vitro drug sensitivity to sulfadoxine/pyrimethamine, in clinical studies the combination of sulfadoxine (IC50 = 40.46 μM, 95% CI: 31.15-51.97; IC90=173.48 μM, 95% CI: 120.78-249.17) and pyrimethamine (IC50 = 1.7 μM, 95% CI: 1.25-2.3; IC90 = 4.83 μM, 95% CI: 3.17-7.37) with quinine proved to be an interesting option for treating uncomplicated falciparum malaria in Bangladesh.

Translated title of the contributionIn vitro antimalarial drug resistance in Southeastern Bangladesh
Original languageGerman
Pages (from-to)58-61
Number of pages4
JournalWiener Klinische Wochenschrift, Supplement
Volume118
Issue number3
DOIs
Publication statusPublished - 1 Dec 2006
Externally publishedYes

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