A study of drug resistance in malaria

P. Melmane, S. Shetty, D. Gulati

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Abstract

Introduction: Malaria is a major public health problem in South-East Asian and African countries - especially India. It is a protozoan disease transmitted by a vector, i.e., female anopheles mosquito in various states of India. The prevalent species of malarial parasite are Plasmodium vivax and P. falciparum. The present study has been undertaken to evaluate the efficacy of various drugs - chloroquine, quinine, doxycycline, and artimisinin (artesunate) combined therapy (ACT) - in uncomplicated vivax and falciparum malarial infection. Material and methods: A total of 120 hospitalised patients in Dr D.Y. Patil Medical College and Hospital, Navi Mumbai; smearpositive cases - 60 each of P. vivax (group A) and P. falciparum or mixed malaria (Group B) - were included. Complicated cases were excluded, i.e., those with target organ damage; complete blood count and parasitic index were done on day I, 4, and 7, in addition to liver, kidney, pulmonary, and cardiac functions Results: The observations revealed that patients of group A responded early to treatment as compared to group B (regarding fever and parasitic index disappearance). The group A did respond partially to chloroquine and statistically significantly to other drugs combinations; whereas group B did not respond to satisfactorily to chloroquine, but had reasonable statistically significant effect with other drugs. Conclusions: The best medications were artesunate and quinine in combination with doxycycline in both the groups (A and B), whereas chloroquine with doxycycline did not fare as well in either group. Thus the artesunate combination therapy (ACT) is emerging as the first-line treatment in drug resistant malaria under the present circumstances.

Original languageEnglish
JournalJournal, Indian Academy of Clinical Medicine
Volume15
Issue number1
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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