Growing malaria resistance to chloroquine, less to Fansidar - WHO

Five studies into the effectiveness of common malaria treatments in western DRC show that there is 25 to 35 percent resistance to chloroquine and less than 5 percent resistance to sulphadoxine-pyrimethamine (Fansidar), according to the World Health Organisation (WHO) DRC country update for July. However, WHO cautioned that studies getting underway in the east would be necessary before the development of new treatment protocols in order to ensure that new approaches are not soon overtaken by resistance problems. “Resistance patterns tend to move from east to west across Africa,” the coordinator for the WHO Roll Back Malaria Initiative for eastern DRC Nadine Ezard said. “In Burundi, 80 to 90 percent of malaria is resistant to chloroquine and a worrying 30 to 50 percent is resistant to Fansidar.” Fansidar is currently the official second line of treatment in the DRC and one of the few remaining inexpensive treatment options. “There is widespread use of chloroquine of dubious quality and dubious dosing in eastern DRC. On top of this, people often do not complete their courses [of treatment]. There is also likely to be significant resistance to [Fansidar] because of the high rate of transmission,” Ezard said. Chloroquine is still the first line of treatment in national protocols, but many health workers prescribe quinine, if patients can afford it. Throughout Africa, there is an increasing drive towards combination therapies involving Fansidar, artemesinin derivatives or amodiaquine. However, as each combination treatment costs the equivalent of an insecticide-coated mosquito bed net, economics will likely force a shift towards such preventative measures, WHO noted.