Imported quinine resistant Plasmodium falciparum malaria in Sri Lanka

Chloroquine still remains the first line drug for treatment of uncomplicated Plasmodium falciparum malaria in Sri Lanka. Sulfadoxine-pyrimethamine (S-P. Fansidar) is used as the main second line drug. Quinine is the drug of choice for complicated P. falciparum malaria. Chloroquine resistant P. falciparum malaria in Sri Lanka was first reported from Dambulla in 1984 [1], and its spread has been identified and reported by the Anti- Malaria Campaign [2]. Resistance to chloroquine and sulfadoxine- pyrimethamine (S-P) has been infrequently reported in Sri Lanka in 1994 [3,4] and in 1996 [5]. More recently, chloroquine resistant P. falciparum malaria has been reported among the security forces personnel in the Mannar district [6]. Quinine resistant P. falciparum malaria has not yet been reported in Sri Lanka. Rare cases of RII and RIII resistance (failure to clear or failure to reduce parasitaemia in the first 7 days) to quinine have been documented in Thailand, Vietnam, tropical Africa and the Amazon region [7-9]. We report here for the first time, imported quinine resistant P. falciparum malaria encountered in Sri Lanka. Key words: Artemisinin; malaria contracted in Nigeria DOI: 10.4038/cmj.v50i3.1432 Ceylon Medical Journal Vol.50(3) 2005: 125-126