Abstract
Surveys conducted in Pakistan during the last decade show that falciparum malaria has become resistant to chloroquine in Pakistani and Afghan refugee populations throughout the country. Although RI resistance is common everywhere (with a frequency of 30%-84%), RII is rarer (2%-36%), and RIII resistance has yet to be detected. The national policy is to prescribe chloroquine as first-line treatment of malaria. A repeated in-vivo survey in a sentinel village indicated that prescription of chloroquine can lead to a 15% increase in the frequency of resistance in a single year, and similar trends were observed in other districts. Coinciding with the spread of resistance is a 6-fold increase in the number of falciparum cases recorded nationally between 1982 and 1992 and a parallel, 5-fold increase in the number of cases recorded in the Afghan refugee population. Resistance contributes to this trend in various ways. Firstly, patients with resistant malaria make repeated visits to health centres. In the sentinel village, for example, where resistance was measured at 71%, recrudescent infections inflated by 66% the genuine incidence of new infections recorded at the health centre. Secondly, owing to ineffective treatment, resistant infec...Continue Reading
Citations
Aug 30, 2000·Tropical Medicine & International Health : TM & IH·M RowlandD Chavasse
Mar 11, 2003·Transactions of the Royal Society of Tropical Medicine and Hygiene·Mark RowlandRobert Wirtz
Jun 28, 2011·Malaria Journal·Natasha HowardMark Rowland
Mar 5, 2004·Tropical Medicine & International Health : TM & IH·Neeru SinghM P Singh
Mar 6, 2004·Annals of Tropical Medicine and Parasitology·J KolaczinskiM Rowland
Dec 3, 2003·Tropical Medicine & International Health : TM & IH·Natasha HowardMark Rowland
Jun 9, 2005·Tropical Medicine & International Health : TM & IH·Naeem DurraniMark Rowland
Nov 7, 2009·Emerging Infectious Diseases·Toby LeslieMark Rowland
Oct 3, 2002·Tropical Medicine & International Health : TM & IH·Mark RowlandNasir Mohammed
Jun 20, 2006·Malaria Journal·Cornelia E RebholzKaspar Wyss
May 13, 2004·Transactions of the Royal Society of Tropical Medicine and Hygiene·Eveline KlinkenbergFelix P Amerasinghe
Sep 30, 2008·Pakistan Journal of Biological Sciences : PJBS·Mohammad Iqbal Yasinzai, Juma Khan Kakarsulemankhel
Mar 5, 2004·Tropical Medicine & International Health : TM & IH·Mark RowlandMohammed Saeed
Jan 6, 2005·Vector Borne and Zoonotic Diseases·Neeru SinghMrigendra Pal Singh
Apr 15, 2005·The New England Journal of Medicine·J Kevin Baird
Mar 6, 2004·Annals of Tropical Medicine and Parasitology·N EzardA W Asha
Sep 2, 2005·Tropical Medicine & International Health : TM & IH·Jan Kolaczinski
Mar 16, 2000·Transactions of the Royal Society of Tropical Medicine and Hygiene·M Rowland, N Durrani
Apr 26, 2012·Malaria Journal·Justin M CohenBruno Moonen
Aug 31, 2013·Malaria Journal·Aamer A KhattakChristopher V Plowe
Jun 11, 2004·Medical and Veterinary Entomology·N HerrelF Konradsen
Jan 29, 2011·Malaria Journal·Najia Karim GhanchiAndreas Mårtensson