In vivo Susceptibility of Plasmodium vivax to Chloroquine in Southeastern Iran
AbstractBackground: Plasmodium vivax is the predominant species causes of malaria with about 90% total annual reported malaria in Iran. This study conducted to determine the susceptibility of Plasmodium vivax isolates to chloroquine in Sistan and Balochistan Province, southeastern Iran.Methods: A total 270 subjects with symptomatic malaria and confirmed P. vivax infection completed the designed 28-day in vivo study. The thick and thin film blood smears were screened for malaria parasites by microscopy. The nested PCR was applied using the Plasmodium 18 subunit ribosomal ribonucleic (Ssr RNA) genes for detecting mixed infections and diagnosis of parasites in the samples with low parasite on days 0, 5, 6, 7, and 28. Results: P. vivax was cleared in 15%, 50%, 95%, and 100% of patients on days 1, 2, 3, 4 respectively by microscopy assessment. Six patients were exhibited specific P. vivax band in nested PCR on day 5. No recurrence was observed on days 7, 14 and 28. Mean (±standard deviation) parasite clearance time was 2.41 (±0.8) days.Conclusion: P. vivax is still susceptible to chloroquine in Southeatern Iran. This finding is compatible with results of neighboring countries Pakistan and Afghanistan.
Danis K, Baka A, Lenglet A, Van Bortel W, Terzaki I, Tseroni M, Detsis M, Papanikolaou E, Balaska A, Gewehr S, Dougas G, Sideroglou T, Economopoulou A, VakalisN, Tsiodras S, Bonovas S, Kremastinou J. Autochthonous Plasmodium vivax malaria in Greece. Euro Surviell. 2011; 16 :1-5.
Yeshwondim AK, Tekle AH, Dengela DO, Yohannes AM. Therapeutic efficacy of chloroquine and chloroquine plus primaquine for the treatment of Plasmodium vivax in Ethiopia. Acta Trop. 2010; 113 :105-13.
Riecmann KH, Davis DR. Plasmodium vivax resistance to chloroquine ? Lancet. 1989; II:1183-4.
Myat-Phone-Kyaw, Myin-Oo, Myint-Lwin, Thaw-Zin, Kyin-Hla-Aye, New-New-Yin. Emergence of chloroquine-resistant Plasmodium vivax in Myanmar (Burma). Trans R SOC Trop Med Hyg. 1993; 87:678.
Dilmec F, Kurcer MA, Akkafa F, Simsek Z. Monitoring of failure of chloroquine treatment for Plasmodium vivax using polymerase chain reaction in Sanliurfa province, Turkey. Parasitol Res. 2010; 106:783-8.
Yohannes AM, Teklehaimanot A, Bergqvist Y, Ringwald P. Confirmed vivax resistance to chloroquine and effectiveness of artemether-lumefantrine for the treatment of vivax malaria in Ethiopia. Am J Trop Med Hyg. 2011; 84:137-40.
Chotivanich K, Sattabongkot J, Choi YK, Park JS, Sritabal J, Lim CS, Udomsangpetch R, White NJ, Lee WJ. Antimalarial drug susceptibility of Plasmodium vivax in the Republic of Korea. Am J Trop Med Hyg. 2009; 80(Suppl 6):902-4.
Schwartz LK, Lackritz EM, Patchen LC . Chloroquine resistant Plasmodium vivax from Indonesia. NEJM. 1991; 324:927-33.
Sutanto I, Suprijanto S, Nurhayati ,Manoempil P, Baird JK. Resistance to chloroquine by Plasmodium vivax at Alor in the Lesser Sundas Archipelago in eastern Indonesia. Am J Trop Med Hyg. 2009; 81:338-42.
Garg M,Gopinathan N, Bodhe P, Kshirsagar NA. vivax malaria resistant to Chloroquine case report from Bombay. Trans R Soc Trop Med Hyg. 1995; 89:656-7.
Soto J, Toledo J, Gutierrez P, Luzz M, Llinas N, Cedeno N, Dunne M, Berman J. Plasmodium vivax clinically resistant to chloroquine in Colombia. Am J Trop Med Hyg. 2011 ;65:90-3.
Awab GR, Pukrittayakamee S, Immwong M, Dondorp AM, Woodrow CL, Lee SJ, Day NPG, Singhasivanon P, White NJ , Kaker F.Dihydroartemisinin-Piperaquine versus Chloroquine to treat vivax malaria in Afghanistan: an open randomized, non – inferiority, trial. Malar J. 2010; 9:105
Valibayov A, Abdullayev F, Mammadov S, Gasimov E, Sabatinelli G, Kondrachine AV, Ringwald D. Clinical efficacy of chloroquine followed by primaquine for Plasmodium vivax treatment in Azerbaijan. Acta Trop. 2003; 88:99-103.
Muhamad P, Ruengweerayut R, Chacharoenkul W, Rungsihirunrat K, Na- Bangchang K. Monitoring of clinical efficacy and in vitro sensitivity of Plasmodium vivax to chloroquine in area along Thai Myanmar border during 2009- 2010. Malar J. 2011; 10:44.
Latichev LN . cited by povlovsky En in: Epidemic parasitology mission to Iran and Parasitological surveys. Acad Sci USSR. 1984:235-8.
Edrissian GH, Nateghpoor M, Afshar A, Sayedzadeh A, Mohsseni GH, Satvat MT, Emadi AM. Monitoring the response of Plasmodium falciparum and P.vivax to antimalarial drugs in the malarious areas in south-east Iran. Arch Iran Med. 1999; 2 :61-6.
Heidari A, Dittrich S, Jelinek T, Kheirandish A, Banihashemi K, Keshavarz H. Genotypes and in vivo resistance of Plasmedium falciparum isolates in an endemic region of Iran. Parasitol Res. 2007; 100: 589-92.
Hamedi Y, Nateghpour M, Tan-ariya P, Tieensuwan M, Silachmroon U, Looareesuwan S. Plasmodium vivax malaria in southeast Iran in 1999-2001:Estabilishing the response to chloroquine in vitro and in vivo .Southeast Asian J Trop Med Public Health. 2002; 33: 512-8.
Nateghpour M, Sayedzadeh SA, EdrissianGh, Raeisi A, Jahantigh A, Motevalli-Haghi A, Mohseni Gh,Rahimi A. Evaluation of sensitivity of Plasmodium vivax to chloroquine. Iranian J Publ Health. 2007; 36:60-3.
21.WHO Malaria profile of Iran 2010;available: www.who.int/malaria/publications/countr y-profiles/profile_irn_en.pdf.
Heidari A, Keshavarz H, Dittrich S,JelinecT. Allelic Dimorphism of the Plasmodium falciparum Erythrocyte Binding Antigen-175 (EBA-175) Gene in the southeast of Iran .Iranian J Parasitol. 2009; 4 (2):17-22
Mardani M, Keshavarz H, HeidariA,Hajaran H, Raeisi A, Khorramizadeh MR. Genetic polymorphism at the Cterminal domain (Region III) of knobassociated histidine-rich protein (KAHRP) of Plasmodium falciparum in isolates from Iran. Parasitol Res. 2011; 109 (6):1647-52.
Zakeri S, Razavi S & Djadid ND . Geneticdiversity of transmission blocking vaccine candidate (Pvs25 and Pvs28) antigen inn Plasmodium vivax clinical isolates from Iran. Acta Trop. 2009; 109: 176–80.
Edrissian GhH . Malaria in Iran: Past andPresent situation. Iranian J Parasitol. 2006; 1:1-14.
WHO . Monitoring Anti-Malarial Drug Resistance. Report of a WHO Consultation.2002; Geneva, Switzerland.
Snounon G, Viriyyakosol S, Zhu XP, JarraW, Pinheiro L, do Rosario VE, Thaithong S, Brown KN. High sensitivity of detection of human malaria parasites by the use of nested Polymerase chain reaction. Mol Biochem Parasitol. 1993; 61:313- 20.
Leslie T, Mayan I, Hasan MA, Safi MH, Klinkenberg E. Sulfadoxine-pyrimethamine, chlorproguanil-dapsone, or chloroquine for the treatment of Plasmodium vivax malaria in Afghanistan and Pakistan: A randomised control trial. JAMA. 2007; 297: 2201–9.
Copyright (c) Iranian Journal of Parasitology
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.