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USE OF A COLORIMETRIC (DELI) TEST FOR THE EVALUATION OF CHEMORESISTANCE OF PLASMODIUM FALCIPARUM AND PLASMODIUM VIVAX TO COMMONLY USED ANTI-PLASMODIAL DRUGS IN THE BRAZILIAN AMAZON
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Abstract
Background: The emergence and spread of Plasmodium falciparum and Plasmodium vivax resistance to available
anti-malarial drugs represents a major drawback in the control of malaria and its associated morbidity and mortality.
The aim of this study was to evaluate the chemoresistance profile of P. falciparum and P. vivax to commonly used
anti-plasmodial drugs in a malaria-endemic area in the Brazilian Amazon.
Methods: The study was carried out in Manaus (Amazonas state), in the Brazilian Amazon. A total of 88 P.
falciparum and 178 P. vivax isolates was collected from 2004 to 2007. The sensitivity of P. falciparum isolates was
determined to chloroquine, quinine, mefloquine and artesunate and the sensitivity of P. vivax isolates was
determined to chloroquine and mefloquine, by using the colorimetric DELI test.
Results: As expected, a high prevalence of P. falciparum isolates resistant to chloroquine (78.1%) was observed. The
prevalence of isolates with profile of resistance or decreased sensitivity for quinine, mefloquine and artesunate was
12.7, 21.2 and 11.7%, respectively. In the case of P. vivax, the prevalence of isolates with profile of resistance for
chloroquine and mefloquine was 9.8 and 28%, respectively. No differences in the frequencies of isolates with profile
of resistance or geometric mean IC50s were seen when comparing the data obtained in 2004, 2005, 2006 and
2007, for all tested anti-malarials.
Conclusions: The great majority of P. falciparum isolates in the Brazilian malaria-endemic area remain resistant to
chloroquine, and the decreased sensitivity to quinine, mefloquine and artesunate observed in 10–20% of the
isolates must be taken with concern, especially for artesunate. Plasmodium vivax isolates also showed a significant
proportion of isolates with decreased sensitivity to chloroquine (first-line drug) and mainly to mefloquine. The data
presented here also confirm the usefulness of the DELI test to generate results able to impact on public health
policies.
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