Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003
Because of instability in eastern Afghanistan, new refugees crossed into the federally administered tribal areas of northwestern Pakistan in 2002. In 2003, we investigated an epidemic of Plasmodium falciparum malaria in 1 of the camps. Incidence was 100.4 cases/1,000 person-years; in other nearby ca...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Centers for Disease Control and Prevention
2009-11-01
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| Series: | Emerging Infectious Diseases |
| Subjects: | |
| Online Access: | https://wwwnc.cdc.gov/eid/article/15/11/09-0886_article |
| _version_ | 1811269393336762368 |
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| author | Toby Leslie Harpakash Kaur Nasir Mohammed Kate Kolaczinski Rosalynn L. Ord Mark Rowland |
| author_facet | Toby Leslie Harpakash Kaur Nasir Mohammed Kate Kolaczinski Rosalynn L. Ord Mark Rowland |
| author_sort | Toby Leslie |
| collection | DOAJ |
| description | Because of instability in eastern Afghanistan, new refugees crossed into the federally administered tribal areas of northwestern Pakistan in 2002. In 2003, we investigated an epidemic of Plasmodium falciparum malaria in 1 of the camps. Incidence was 100.4 cases/1,000 person-years; in other nearby camps it was only 2.1/1,000 person-years. Anopheline mosquitoes were found despite an earlier spray campaign. Documented clinical failures at the basic health unit prompted a drug resistance survey of locally manufactured sulfadoxine-pyrimethamine used for routine treatment. The in vivo failure rate was 28.5%. PCR analysis of the P. falciparum dihydrofolate reductase and dihyropteroate synthase genes showed no mutations associated with clinical failure. However, chemical analysis of the drug showed that it was substandard. As global incidence decreases and epidemics become more of a threat, enhanced quality assurance of control interventions is essential. |
| first_indexed | 2024-04-12T21:41:13Z |
| format | Article |
| id | doaj.art-8a573c7802864f68acb473ead65545eb |
| institution | Directory Open Access Journal |
| issn | 1080-6040 1080-6059 |
| language | English |
| last_indexed | 2024-04-12T21:41:13Z |
| publishDate | 2009-11-01 |
| publisher | Centers for Disease Control and Prevention |
| record_format | Article |
| series | Emerging Infectious Diseases |
| spelling | doaj.art-8a573c7802864f68acb473ead65545eb2022-12-22T03:15:45ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592009-11-0115111753175910.3201/eid1511.090886Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003Toby LeslieHarpakash KaurNasir MohammedKate KolaczinskiRosalynn L. OrdMark RowlandBecause of instability in eastern Afghanistan, new refugees crossed into the federally administered tribal areas of northwestern Pakistan in 2002. In 2003, we investigated an epidemic of Plasmodium falciparum malaria in 1 of the camps. Incidence was 100.4 cases/1,000 person-years; in other nearby camps it was only 2.1/1,000 person-years. Anopheline mosquitoes were found despite an earlier spray campaign. Documented clinical failures at the basic health unit prompted a drug resistance survey of locally manufactured sulfadoxine-pyrimethamine used for routine treatment. The in vivo failure rate was 28.5%. PCR analysis of the P. falciparum dihydrofolate reductase and dihyropteroate synthase genes showed no mutations associated with clinical failure. However, chemical analysis of the drug showed that it was substandard. As global incidence decreases and epidemics become more of a threat, enhanced quality assurance of control interventions is essential.https://wwwnc.cdc.gov/eid/article/15/11/09-0886_articleMalariaepidemicparasitesantimalarial drugsPlasmodium falciparumrefugees |
| spellingShingle | Toby Leslie Harpakash Kaur Nasir Mohammed Kate Kolaczinski Rosalynn L. Ord Mark Rowland Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003 Emerging Infectious Diseases Malaria epidemic parasites antimalarial drugs Plasmodium falciparum refugees |
| title | Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003 |
| title_full | Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003 |
| title_fullStr | Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003 |
| title_full_unstemmed | Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003 |
| title_short | Epidemic of Plasmodium falciparum Malaria Involving Substandard Antimalarial Drugs, Pakistan, 2003 |
| title_sort | epidemic of plasmodium falciparum malaria involving substandard antimalarial drugs pakistan 2003 |
| topic | Malaria epidemic parasites antimalarial drugs Plasmodium falciparum refugees |
| url | https://wwwnc.cdc.gov/eid/article/15/11/09-0886_article |
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