Monitoring the Response of Plasmodium vivax to Chloroquine and Uncomplicated P. falciparum to Artesunate-fansidar Anti-malarials in Southeastern Iran
AbstractBackground: For many years, malaria was a major life-threatening parasitic infection in Iran. Although malaria elimination program is implementing in the country, still some cases annually are reported from malaria-endemic areas.Methods: This study was conducted in five malaria endemic districts of Sistan and Baluchistan Province, southeastern Iran, neighboring Afghanistan and Pakistan countries. Overall, 170 and 38 vivax malaria and falciparum malaria infected patients were enrolled in the study from 2013-2014. All the cases were selected according to criteria of the WHO guideline for in vivo drug sensitivity tests in malaria parasites. Evaluation of drug sensitivity test was conducted with some modifications.Results: The patients with vivax malaria responded to the regimen of chloroquine in 37.4(±15.9), 40(±13.8) and 42(±17.7) h for Pakistani, Iranian and Afghani nationalities respectively based on MPCT evaluation. The results showed a considerable difference between them and Iranian subjects. MPCT for the patients with falciparum malaria was calculated as 28(±18.05), 26(±12.03) and 36(±16.9) h for Iranian, Pakistani and Afghani nationalities respectively. There was a marginally significant difference between Afghani and other nationalities and between males and females.Conclusion: Treatment of all the patients resulted in ACPR and MPCT of P. vivax showed that the parasite became more sensitive to chloroquine than previous years in studied areas.
Ministry of Health and Medical Education. Annual report of malaria control depart-ment. Tehran, Iran: Centre for Communi-cable Disease Management; 2015.
Waheed AA, Ghanchi NK, Rehman KA et al. Vivax malaria and chloroquine re-sistance: a neglected disease as an emerg-ing threat. Malar J. 2015;14:146.
Mebrahtu E. Antimalarial drug resistance: In the past, current status and future per-spectives. Br J Pharmacol Toxicol. 2015; 6(1):1-15.
Marques MM, Costa MR, Santana Filho FS et al. Plasmodium vivax chloroquine re-sistance and anemia in the western Brazili-an Amazon. Antimicrob Agents Chemother. 2014;58(1):342-7.
Edrissian GH, Shahabi S. Preliminary study of the response of Plasmodium falcipa-rum to chloroquine in Sistan and Baluchestan province of Iran. Trans R Soc Trop Med Hyg. 1985;79(4):563-4.
Edrissian GhH, Nateghpour M, Afshar A, Sayedzadeh A, Mohsseni Gh, Satvat MT, Emadi AM. Monitoring the Response of Plasmodium falciparum and P. vivax to Anti-malarial Drugs in the Malarious Areas in South-East Iran. Arch Iran Med. 1999; 2(2):61-6.
Edrissian GhH, Nateghpour M, Afshar A, Mohseni GH. In vivo monitoring of the response of falciparum and vivax plasmodia to chloroquine in Bandar Abbas and Kahnoudj, South-East Iran, 1997-1999. Med J Iran Hosp. 2001; 3:30-3.
Hamedi Y, Nateghpour M, Tan-ariya P, Tiensuwan M, Silachamroon U, Looa-reesuwan S. Plasmodium vivax malaria in Southeast Iran in 1999-2001: establishing the response to chloroquine in vitro and in vivo. Southeast Asian J Trop Med Public Health. 2002; 33(3):512-8.
Raeisi A, Ringwald P, Safa O, Shahbazi A, Ranjbar M, Keshavarz H, Nateghpour M, Faraji L. Monitoring of the therapeutic ef-ficacy of chloroquine for the treatment of uncomplicated, Plasmodium falciparum malaria in Iran. Ann Trop Med Parasitol. 2006;100(1):11-6.
Nateghpour M, Sayedzadeh SA, Edrissian GhH, Raeisi A, Jahantigh A, Motevalli Haghi A, Mohseni Gh, Rahimi A. Evalua-tion of sensitivity of Plasmodium vivax to chloroquine. Iran J Publ Health. 2007; 36(3):60-63.
Nateghpour M, Edrissian GhH, Torabi E, Raeisi A, Motevalli Haghi A, Abed Khoja-steh H, Gobakhloo N. Monitoring the sensitivity of Plasmodium vivax and falciparum to chloroquine in Bandar-Abbas, Hor-mozgan province. Tehran Univ Med J. 2009; 67(3):178-183.
World Malaria Report, 2014. Geneva, World Health Organization, 2014. (http://malaria.who.int/ cam-paigns/malaria-day/2014/en/ 24aApril 2014).
Saebi E, Ranjbar M, Nabavi M et al. Malar-ia Treatment Guideline in I.R.Iran. Ministry of Medical Education; 2007.
Edrissian GH. Status of the response of Plasmodium falciparum to chloroquine and mefloquine in Iran. Trop Geogr Med. 1989;41(4):297-303.
Edrissian GH, Afshar A, Sayedzadeh A, Mohsseni G, Satvat MT. Assessment of the response in vivo and in vitro of Plas-modium falciparum to sulphadoxine-pyrimethamine in the malarious areas of Iran. J Trop Med Hyg. 1993;96(4):237-40.
Eskandarian AA, Keshavarz H, Basco LK, Mahboudi F. Do mutations in Plasmodium falciparum dihydropteroate synthase and di-hydrofolate reductase confer resistance to sulfadoxine-pyrimethamine in Iran? Trans R Soc Trop Med Hyg. 2002;96(1):96-8.
Sharifi-Sarasiabi K, Haghighi A, Kazemi B, Taghipour N, Mojarad EN, Gachkar L. Molecular surveillance of Plasmodium vivax and Plasmodium falciparum DHFR mutations in isolates from southern Iran. Rev Inst Med Trop Sao Paulo. 2016; 58:16.
Heidari A, Keshavarz H, Shojaee S, Raeisi A, Dittrich S. In vivo susceptibility of Plas-modium vivax to chloroquine in southeastern Iran. Iran J Parasitol. 2012;7(2):8-14.
Collingon P. Chloroquine Resistance in Plasmodium vivax. J Infect Dis. 1991; 164(1):222-223.
Garavelli PL, Corti E. Chloroquine re-sistance in Plasmodium vivax: the first case in Brazil. Trans R Soc Trop Med Hyg. 1992;86(2):128..
Schuurkamp GJ, Spicer PE, Kereu RK, Bulungol PK, Rieckmann KH. Chloroquine- resistant Plasmodium vivax in Papua New Guinea. Trans R Soc Trop Med Hyg. 1992; 86(2):121-2.
Singh RK. Emergence of Chloroquine- resistant vivax malaria in south Bihar (In-dia). Trans R Soc Trop Med Hyg. 2000; 94(3):327.
Soto J, Toledo J, Gutierrez P, Luzz M, Lli-nas N, Cedeño N, Dunne M, Berman J. Plasmodium vivax clinically resistant to chloroquine in Colombia. Am J Trop Med Hyg. 2001;65(2):90-3.