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Use of a colorimetric (DELI) test for the evaluation of chemoresistance of Plasmodium falciparum and Plasmodium vivax to commonly used anti-plasmodial drugs in the Brazilian Amazon

Lilian R Pratt-Riccio12, Yonne F Chehuan3, Maria José Siqueira3, Maria das Graças Alecrim3, Cesare Bianco-Junior12, Pierre Druilhe4, Philippe Brasseur5, Maria de Fátima Ferreira-da-Cruz12, Leonardo JM Carvalho12 and Cláudio T Daniel-Ribeiro12*

Author Affiliations

1 Laboratório de Pesquisas em Malária, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil CEP: 21040-900

2 Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz, Reference Center for Malaria in the Extra-Amazonian Region for the Secretary for Health Surveillance from the Ministry of Health, Rio de Janeiro, RJ, Brazil

3 Laboratório de Malária, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil

4 Institut Pasteur, Paris, France

5 UMR 198, Institut de Recherche pour le Développement, Dakar, Sénégal, Bangladesh

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Malaria Journal 2013, 12:281  doi:10.1186/1475-2875-12-281

Published: 12 August 2013

Abstract

Background

The emergence and spread of Plasmodium falciparum and Plasmodium vivax resistance to available anti-malarial drugs represents a major drawback in the control of malaria and its associated morbidity and mortality. The aim of this study was to evaluate the chemoresistance profile of P. falciparum and P. vivax to commonly used anti-plasmodial drugs in a malaria-endemic area in the Brazilian Amazon.

Methods

The study was carried out in Manaus (Amazonas state), in the Brazilian Amazon. A total of 88 P. falciparum and 178 P. vivax isolates was collected from 2004 to 2007. The sensitivity of P. falciparum isolates was determined to chloroquine, quinine, mefloquine and artesunate and the sensitivity of P. vivax isolates was determined to chloroquine and mefloquine, by using the colorimetric DELI test.

Results

As expected, a high prevalence of P. falciparum isolates resistant to chloroquine (78.1%) was observed. The prevalence of isolates with profile of resistance or decreased sensitivity for quinine, mefloquine and artesunate was 12.7, 21.2 and 11.7%, respectively. In the case of P. vivax, the prevalence of isolates with profile of resistance for chloroquine and mefloquine was 9.8 and 28%, respectively. No differences in the frequencies of isolates with profile of resistance or geometric mean IC50s were seen when comparing the data obtained in 2004, 2005, 2006 and 2007, for all tested anti-malarials.

Conclusions

The great majority of P. falciparum isolates in the Brazilian malaria-endemic area remain resistant to chloroquine, and the decreased sensitivity to quinine, mefloquine and artesunate observed in 10–20% of the isolates must be taken with concern, especially for artesunate. Plasmodium vivax isolates also showed a significant proportion of isolates with decreased sensitivity to chloroquine (first-line drug) and mainly to mefloquine. The data presented here also confirm the usefulness of the DELI test to generate results able to impact on public health policies.

Keywords:
Malaria; Plasmodium falciparum; Plasmodium vivax; Resistance; Anti-malarials; DELI test