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Chloroquine resistant falciparum malaria among security forces personnel in the Northern Province of Sri Lanka

Authors:

HAC Hapuarachchi ,

Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama., LK
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MYD Dayanath,

Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama., LK
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S Abeysundara,

Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama., LK
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KBAT Bandara,

Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama., LK
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W Abeyewickreme,

Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama., LK
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NR de Silva

Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama., LK
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Abstract

Objective To determine the occurrence and species distribution of malaria and the extent of chloroquine resistance among security forces personnel in a selected region of the Northern Province of Sri Lanka. Design A descriptive study. Setting Mannar District in the Northern Province.

Methods Nine hundred and seventy five security personnel were screened for malaria by microscopy. Those who were positive were treated with chloroquine and were subjected to 28 day in vivo assay to determine chloroquine resistance. In vitro microtest assay was performed to determine the response of Plasmodium falciparum isolates to chloroquine in vitro.

Results Of the 975 personnel screened, 181 (18.6%) were positive for malaria. P. falciparum was the predominant species (n = 125; 69.1%). The rest were due to P. vivax (n = 42; 23.2%) and mixed infections (n = 14; 7.7%). This was an inversion of the usual species distribution pattern in the country. In vivo assay revealed 38 (53.5%) P. falciparum infections as chloroquine resistant. Fifteen of 23 (65.2%) P. falciparum isolates showed evidence of resistance in vitro. None of the P. vivax infections showed evidence of chloroquine resistance. There was no significant difference in the severity of clinical disease between chloroquine resistant and sensitive infections at first presentation. Recrudescent P. falciparum infections had significantly lower mean parasite densities as well as lower clinical scores at recrudescence than at first presentation.

Conclusion Results demonstrate the high prevalence of malaria and chloroquine resistance in the study area and explains several contributory factors for this. There is an urgent need to review antimalarial drug policies in Sri Lanka.

(Index words: drug resistance, Plasmodium falciparum, Plasmodium vivax, soldiers)

DOI: http://dx.doi.org/10.4038/cmj.v49i2.3260

Ceylon Medical Journal 2004; 49: 47-51

DOI: http://doi.org/10.4038/cmj.v49i2.3260
How to Cite: Hapuarachchi, H. et al., (2011). Chloroquine resistant falciparum malaria among security forces personnel in the Northern Province of Sri Lanka. Ceylon Medical Journal. 49(2), pp.47–51. DOI: http://doi.org/10.4038/cmj.v49i2.3260
Published on 15 Aug 2011.
Peer Reviewed

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