23 October 2012

Nigeria: Chloroquine Making a Comeback Against Malaria?

Photo: Mandela Metro
Nelson Mandela Staium in Port Elizabeth. South Africa

Several years after it was banned as the first line drug for treatment of uncomplicated malaria, Chloroquine, one of the oldest anti-malaria drugs, appears to be gradually making a comeback.

A decade and a half ago, Chloroquine was one of the most popular and efficacious anti-malaria drugs in the world. It remains one of the few drugs that can be safely taken in early pregnancy,

Chloroquine was in use for more than 50 years before misuse and adulteration led to development of resistance by the malaria parasite and subsequent ban of the drug by the World Health Organisation. Nigeria banned chloroquine as first line drug of treatment in 2005.

But resistance monitoring tests carried out at the University of Copenhagen, show that the previously efficacious drug is once again beginning to work against malaria.

Tests by resistance monitoring show that in a number of African countries, malaria parasites are succumbing to the formerly used drug chloroquine. The tests were carried out by Associate Professor at the Center for Medical Parasitology at the University of Copenhagen, Dr. Michael Alifrangis, along with Magatte Ndiaye, a PhD student at Université Cheikh Anta Diop in Senegal.

In excerpts of a study published in the American Journal of Tropical Medicine and Hygiene, Alifrangis noted that up to 70 percent of the malaria parasites found in Senegal are reacting once again to chloroquine.

"This is a trend we have also seen in Tanzania and Mozambique, and which other researchers have shown in Malawi. Our choice of drugs against malaria is limited and related, so when the malaria parasite once again reacts to a substance, it influences several treatment methods."

Malaria-drug monitoring shows that malaria parasites ultimately develop resistance to medicine,and scientists and healthcare personnel are currently worried that the malaria parasite will develop resistance to the current frontline treatment against malaria, Artemisinin-based Combination Therapies, ACTs.

It is believed that if healthcare personnel in developing countries can begin using chloroquine again, it will open up promising perspectivesfor protection of currently used medicine and delay reappearance of resistance, while giving a large group of patients access to cheaper treatment.

Reports show that chloroquine costs only N400.00 (25 US cents) for a four-day cure, while the current and corresponding ACTs cost N3,200 (US$2).

Experts say reuse will require correct drug use and the training of healthcare personnel to make more accurate diagnoses.

It is generally expected that in the near future, chloroquine and other malaria drugs not currently on the market will presumably be used again, but only if given in combination with other medicine and only to patients with a certain immunity to malaria.

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