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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.

malaria journal

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