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  • Title: Susceptibility of Plasmodium falciparum to chloroquine amodiaquine and Fansidar in Gujranwala district.
    Author: Nasreen T.
    Journal: Pak J Med Res; 1987; 26(4):186-91. PubMed ID: 12290515.
    Abstract:
    Mass blood surveys were carried out in selected localities of Chindiala, Shergarh, and Maha Chattha in Gujranwala district, Pakistan, on December 22 and 23, 1985. Parasite density per cubic mm of blood was determined. The Slide Positivity Rate was 45.1%. After the surveys, 51 falciparum malaria cases were selected for in vivo trial in the village of Maha Chatha. The remaining cases which were not selected were given radical treatment for malarial infections. The majority of falciparum malaria cases (69%) demonstrated resistance against chloroquine by the in vivo test. Follow up after chloroquine treatment was completed in all 51 cases. The examination of follow up slides showed that all the blood smears became negative by day 7 except in 3 cases, which remained positive up to day 7 (R-II resistant cases). In 29 cases, recrudescence of patient parasitemia was observed between day 7 to day 28. Approximately half of the R-I cases (clearance of patient parasitemia by day 7) recrudesced early, within the first 2 weeks and the other half during the 3rd and 4th week. When the 31 chloroquine-resistant falciparum infections were treated with amodiaquine, 19 cases were cured (61%). All R-1 cases recrudesced within 2 weeks. Fansidar tablets were administered to 12 cases, who did not respond to amodiaquine treatment and 1 chloroquine resistant falciparum infection (recrudescence of patient infection on day 28). The examination of follow-up blood smears showed that 12 of the 13 cases treated with Fansidar were sensitive, only 1 case was resistant with asexual parasites. Fansidar cured 92% of infections resistant to both chloroquine and amodiaquine. In amodiaquine treated cases, the pre-treatment parasitemias of the resistant cases were much higher than those from sensitive cases. Fansidar should only be given in those cases of blood smear confirmed falciparum infection that are not cured by a 3-day treatment with a total dose of 25 mg base/kg body weight of chloroquine.
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