Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data
Abstract Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP) resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT) for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use w...
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ftdoajarticles:oai:doaj.org/article:b88807cb3acb41ff8b430ebccb8ca36b 2023-05-15T15:14:31+02:00 Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data Venkatesan Meera Frosch Anne EP Laufer Miriam K 2011-05-01T00:00:00Z https://doi.org/10.1186/1475-2875-10-116 https://doaj.org/article/b88807cb3acb41ff8b430ebccb8ca36b EN eng BMC http://www.malariajournal.com/content/10/1/116 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-116 1475-2875 https://doaj.org/article/b88807cb3acb41ff8b430ebccb8ca36b Malaria Journal, Vol 10, Iss 1, p 116 (2011) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2011 ftdoajarticles https://doi.org/10.1186/1475-2875-10-116 2022-12-31T05:50:36Z Abstract Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP) resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT) for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use was followed by the re-emergence of chloroquine-susceptible malaria. It was expected that introduction of ACT would lead to a return in chloroquine susceptibility throughout Africa, but this has not yet widely occurred. This observation suggests that there is continuing use of ineffective anti-malarials in Africa and that persistent chloroquine-resistant malaria is due to ongoing drug pressure despite national policy changes. Methods To estimate drug use on a national level, 2006-2007 Demographic Health Survey and Multiple Indicator Cluster Survey data from 21 African countries were analysed. Resistance data were compiled by systematic review of the published literature on the prevalence of the Plasmodium falciparum chloroquine resistance transporter polymorphism at codon 76, which causes chloroquine resistance. Results Chloroquine was the most common anti-malarial used according to surveys from 14 of 21 countries analysed, predominantly in West Africa. SP was most commonly reported in two of 21 countries. Among eight countries with longitudinal molecular resistance data, the four countries where the highest proportion of children treated for fever received chloroquine (Uganda, Burkina Faso, Guinea Bissau, and Mali) also showed no significant declines in the prevalence of chloroquine-resistant infections. The three countries with low or decreasing chloroquine use among children who reported fever treatment (Malawi, Kenya, and Tanzania) had statistically significant declines in the prevalence of chloroquine resistance. Conclusions This study demonstrates that in 2006-2007, chloroquine and SP continued to be used at high rates in many African countries. In countries reporting sustained chloroquine use, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 10 1 116 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Venkatesan Meera Frosch Anne EP Laufer Miriam K Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP) resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT) for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use was followed by the re-emergence of chloroquine-susceptible malaria. It was expected that introduction of ACT would lead to a return in chloroquine susceptibility throughout Africa, but this has not yet widely occurred. This observation suggests that there is continuing use of ineffective anti-malarials in Africa and that persistent chloroquine-resistant malaria is due to ongoing drug pressure despite national policy changes. Methods To estimate drug use on a national level, 2006-2007 Demographic Health Survey and Multiple Indicator Cluster Survey data from 21 African countries were analysed. Resistance data were compiled by systematic review of the published literature on the prevalence of the Plasmodium falciparum chloroquine resistance transporter polymorphism at codon 76, which causes chloroquine resistance. Results Chloroquine was the most common anti-malarial used according to surveys from 14 of 21 countries analysed, predominantly in West Africa. SP was most commonly reported in two of 21 countries. Among eight countries with longitudinal molecular resistance data, the four countries where the highest proportion of children treated for fever received chloroquine (Uganda, Burkina Faso, Guinea Bissau, and Mali) also showed no significant declines in the prevalence of chloroquine-resistant infections. The three countries with low or decreasing chloroquine use among children who reported fever treatment (Malawi, Kenya, and Tanzania) had statistically significant declines in the prevalence of chloroquine resistance. Conclusions This study demonstrates that in 2006-2007, chloroquine and SP continued to be used at high rates in many African countries. In countries reporting sustained chloroquine use, ... |
format |
Article in Journal/Newspaper |
author |
Venkatesan Meera Frosch Anne EP Laufer Miriam K |
author_facet |
Venkatesan Meera Frosch Anne EP Laufer Miriam K |
author_sort |
Venkatesan Meera |
title |
Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data |
title_short |
Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data |
title_full |
Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data |
title_fullStr |
Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data |
title_full_unstemmed |
Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data |
title_sort |
patterns of chloroquine use and resistance in sub-saharan africa: a systematic review of household survey and molecular data |
publisher |
BMC |
publishDate |
2011 |
url |
https://doi.org/10.1186/1475-2875-10-116 https://doaj.org/article/b88807cb3acb41ff8b430ebccb8ca36b |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 10, Iss 1, p 116 (2011) |
op_relation |
http://www.malariajournal.com/content/10/1/116 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-116 1475-2875 https://doaj.org/article/b88807cb3acb41ff8b430ebccb8ca36b |
op_doi |
https://doi.org/10.1186/1475-2875-10-116 |
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Malaria Journal |
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10 |
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116 |
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