Drug-Resistant Malaria - libdoc.who.int - World Health Organization

REVIEW / 17
Other Studies
Validation and development studies were carried out on the
micro in vitro test on the response of P.falciparum to antimalarial
drugs. Studies using this technique with chloroquine were
conducted in Burma, India, Indonesia, Sri Lanka and Thailand. In
Sri Lanka the technique was used to compare the response to
chloroquine and amodiaquine, while in Thailand it was employed to
study the response to chloroquine, quinine and mefloquine.
In Burma studies on the drug combinations sulfadoxinepyrimethamine
and sulfalene-pyrimethamine have indicated that both
combinations produce similar clinical results although with a
higher number of early recrudescences in the suI falene/pyrimethamine
group. A small percentage of patients included 1n the
studies failed to respond a priori.
A scientist from Thailand was given the opportunity of
visiting Sri Lanka to collect P.falciparum isolates for
characterization studies. Using the continuous culture method the
isolates have been shown to be highly sens1t1ve to chloroquine,
amodiaquine, quinine, pyrimethamine and mefloquine.
Under a research grant, a scientist at Chiengmai University,
Thailand, has commenced a study on the metabolic fate of sulfadoxine
and on the correlation between the host's metabolic activity
and the effect of the sulfadoxine/pyrimethamine combination.
A scientist of the Department of Medical Research, Rangoon,
Burma, was given the opportunity of carrying out a comparative
study of the in vivo and in vitro micro tests for the response of
P.falciparum to chloroquine.
Coordination
The Regional Office has continued to provide coordination and
technical guidance and to assist in training and in the planning
of studies. Exchange of information between the countries 1S
arranged by the Regional Office through correspondence and by
conducting review meetings. These review meetings are planned on
a bi-annual basis.
Training
National training has been stepped up 1n Indonesia with the
assistance of a WHO team. This has enabled the country to expand
the number of monitoring teams. In India further training was
postponed for various reasons, but a priority programme is being
developed to introduce the micro in vitro technique. An increase
of the monitoring teams from 6 to 12 has been envisaged.