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Am. J. Trop. Med. Hyg., 76(4), 2007, pp. 614-618
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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UNUSUAL PATTERN OF PLASMODIUM FALCIPARUM DRUG RESISTANCE IN THE NORTHWESTERN PERUVIAN AMAZON REGION

SALOMÓN DURAND, WILMER MARQUIÑO, CESAR CABEZAS, GREGORY UTZ, VICTOR FIESTAS, JAVIER CAIRO, MARITZA PURAY, CARMEN LUCAS, CAROLA SALAS, SONIA GUTIERREZ, NANCY ARROSPIDE, DAVID J. BACON, AND TRENTON K. RUEBUSH, II*
U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Lima, Peru

High levels of Plasmodium falciparum resistance to both chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) have been documented throughout the Amazon Basin of South America. Because of reports about the persistent efficacy of both of these drugs in the northwestern Peruvian Amazon region, we carried out an evaluation of the therapeutic efficacy of chloroquine (25 mg/kg) and SP (25 mg/kg of the sulfadoxine component) for the treatment of uncomplicated P. falciparum infections at two sites: Ullpayacu and Pampa Hermoza/Alianza. A total of 111 patients were enrolled. Only 5 (14.3%) of the 35 patients who received CQ had an adequate clinical and parasitologic response (ACPR). Six subjects (17%) had early treatment failure, 1 (2.9%) had late clinical failure, and 23 (65.7%) had late parasitologic failure (LPF). Of the subjects treated with SP, 92.3% had ACPR and 7.7% had LPF. Based on these findings, it is clear that there are at least limited areas within the Peruvian Amazon region where P. falciparum strains continue to be sensitive to SP.

Received October 4, 2005. Accepted for publication August 21, 2006.

Financial support: This study was supported by DoD-GEIS Work Unit 847705 82000 25GB B0016 and by USAID-Government of Peru, VIGIA Project addressing Threats of Emerging and Re-Emerging Infectious Diseases (Activity 527-0391).

Disclaimer: The opinions and assertions expressed herein are those of the authors and do not necessarily reflect the official policy or position of the U.S. Departments of the Navy or Army, the U.S. Government, or any other organization listed.

* Address correspondence to Trenton K. Ruebush II, Bureau for Global Health, U.S. Agency for International Development, 1300 Pennsylvania Avenue, NW, Washington, DC 20523. E-mail: truebush{at}usaid.gov

Authors’ addresses: Salomón Durand, Gregory Utz, Javier Cairo, Carmen Lucas, Carola Salas, David J. Bacon, and Trenton K. Ruebush II, U.S. Naval Medical Research Center Detachment, Lima, Peru. Wilmer Marguiño, Cesar Cabezas, Victor Fiestas, Maritza Puray, Sonia Gutierrez, and Nancy Arrospide, National Institute of Health, Lima, Peru.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.