Suspected Plasmodium falciparum resistance to artesunate in Cameroon: A case report

2021 ◽  
pp. 004947552110118
Author(s):  
Elie Nkwabong ◽  
Claudine Tseunwo ◽  
Yvette Nkene Mawamba
Keyword(s):  
Plasmodium Falciparum ◽  
Clinical Signs ◽  
Perinatal Outcomes ◽  
Careful Monitoring ◽  
First Line ◽  
Recommended Dosage ◽  
Injectable Artesunate ◽  
Favourable Evolution ◽  
First Line Treatment ◽  
In Pregnancy

Malaria in pregnancy is associated with adverse maternal and perinatal outcomes. The first-line treatment for severe malaria in the second and third trimesters of pregnancy is parenteral artesunate, according to WHO recommendations. Resistance of Plasmodium falciparum to artesunate has not yet been noted in our country. We report a case highly suspicious of such. A pregnant woman presented with the clinical signs of malaria. After paraclinical confirmation of the diagnosis, she was admitted and injectable artesunate was given for 72 h at the recommended dosage, with antipyretic without any improvement. Artesunate was therefore replaced by parenteral quinine, with favourable evolution. Resistance of Plasmodium falciparum to artesunate might be present in our country. This patient provides a warning about possible artesunate resistance, and this calls for careful monitoring of other cases of malaria been treated with this drug to ascertain the possibility of resistant cases.

scholarly journals The use of intravenous iron in pregnancy: for whom and when? A survey of Australian and New Zealand obstetricians

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Smith-Wade ◽  
Giselle Kidson-Gerber ◽  
Antonia Shand ◽  
Luke Grzeskowiak ◽  
Amanda Henry
Keyword(s):  
New Zealand ◽  
Iron Deficiency ◽  
Online Survey ◽  
Controlled Trial ◽  
Perinatal Outcomes ◽  
Intravenous Iron ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
In Pregnancy

Abstract Background Iron deficiency anaemia in pregnancy (IDAP) affects 11–18% of Australian pregnancies and is associated with adverse perinatal outcomes. National prescribing data suggests the use of intravenous iron in pregnancy is increasingly common. This study aimed to: 1) Establish the current patterns of intravenous iron use by Fellows of the Royal Australian and New Zealand College of Obstetricians (FRANZCOG) when treating iron deficiency and IDAP including immediately postpartum and; 2) Assess FRANZCOG opinions regarding potential trial of intravenous iron for first-line treatment of IDAP. Methods An online survey of RANZCOG Fellows practicing obstetrics was distributed in September 2018. Results were analysed descriptively and responses compared by clinician demographics using Chi-squared testing. Results Of 484 respondents (21% of FRANZCOG), 457 were currently practicing obstetrics. Most prescribed intravenous iron in pregnancy (96%) and/or postpartum (85%). Most intravenous iron was prescribed for IDAP (98%) rather than iron deficiency without anaemia (53%), and for IDAP most commonly second-line to failed oral iron supplementation and first-line in special circumstances (59%). Intravenous iron prescribing was associated with shorter time since FRANZCOG completion (p = 0.01), public hospital practice (p = 0.008) and higher hospital birth numbers (p = 0.01). Most respondents (90%) would consider a randomised controlled trial of first-line intravenous iron for IDAP, although views on appropriate thresholds differed. Conclusions Almost all respondents prescribed intravenous iron for IDAP, and while mostly used for second-line treatment over half sometimes used it first-line. With accelerating intravenous iron use, further research is required into its optimal use in pregnancy, recognizing important clinical outcomes and cost effectiveness.

scholarly journals Decline in Sulfadoxine-Pyrimethamine-Resistant Alleles after Change in Drug Policy in the Amazon Region of Peru

2007 ◽  
Vol 52 (2) ◽  
pp. 739-741 ◽  
Author(s):  
Zhiyong Zhou ◽  
Sean M. Griffing ◽  
Alexandre Macedo de Oliveira ◽  
Andrea M. McCollum ◽  
Wilmer Marquino Quezada ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Drug Policy ◽  
Amazon Basin ◽  
Microsatellite Analysis ◽  
Amazon Region ◽  
Common Origin ◽  
Line Treatment ◽  
Peruvian Amazon ◽  
First Line ◽  
First Line Treatment

ABSTRACT The frequency of alleles with triple mutations conferring sulfadoxine-pyrimethamine (SP) resistance in the Peruvian Amazon Basin has declined (16.9% for dhfr and 0% for dhps compared to 47% for both alleles in 1997) 5 years after SP was replaced as the first-line treatment for Plasmodium falciparum malaria. Microsatellite analysis showed that the dhfr and dhps alleles are of common origin.

scholarly journals Review of NVP and HG and Early Pharmacotherapeutic Intervention

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Shannon M. Clark ◽  
Maged M. Costantine ◽  
Gary D. V. Hankins
Keyword(s):  
Medical Condition ◽  
Signs And Symptoms ◽  
Hormonal Changes ◽  
Line Treatment ◽  
Pyridoxine Hydrochloride ◽  
First Line ◽  
Common Medical Condition ◽  
Related Approach ◽  
First Line Treatment ◽  
In Pregnancy

NVP occurs in 50–90% of pregnancies, making it a common medical condition in pregnancy. Women present differently with any combination of signs and symptoms. It is appropriate to take the pregnancy-related versus nonpregnancy-related approach when determining the cause of nausea and vomiting but other causes should be considered. The most common etiologies for NVP include the hormonal changes associated with pregnancy, the physiologic changes in the gastrointestinal tract, and a genetic predisposition. Up to 10% of women will require pharmacotherapy to treat the symptoms of NVP despite conservative measures. ACOG currently recommends that a combination of oral pyridoxine hydrochloride and doxylamine succinate be used as first-line treatment for NVP if pyridoxine monotherapy does not relieve symptoms. A review of NVP and early pharmacotherapeutic management is presented due to the fact that NVP is largely undertreated, and investigations into the safe and effective pharmacotherapies available to treat NVP are lacking.

scholarly journals The Drug Resistance of Plasmodium falciparum and P. vivax in Iran: A Review Article

2021 ◽  
Author(s):  
Aliehsan Heidari ◽  
Hossein Keshavarz
Keyword(s):  
Plasmodium Falciparum ◽  
Antimalarial Drugs ◽  
Review Article ◽  
Transporter Gene ◽  
First Line ◽  
Dihydropteroate Synthase ◽  
The World ◽  
Emergence Of Resistance ◽  
Different Parts ◽  
First Line Treatment

Background: One of the main obstacles to malaria control in the world has been the emergence of resistance in Plasmodium falciparum to chloroquine and other antimalarial drugs. This study aimed to review studies in Iran on resistance in P. falciparum and P. vivax to drugs, and to reveal the mechanisms and molecular markers of resistance of these two species. Methods: The databases of PubMed, Scopus, Google Scholar, Magiran, and reputable Iranian journals were searched to find published studies on the resistance in P. falciparum and P. vivax to antimalarial drugs in Iran. Results: There is a significant relationship between resistance to chloroquine in P. falciparum and the emergence of K76T mutation in the P. falciparum chloroquineresistance transporter gene in Iran. Resistance to sulfadoxine-pyrimethamine (SP) in P. falciparum is also significantly associated with the development of mutations in the dihydrofolate reductase and dihydropteroate synthase genes. Resistance to chloroquine in P. vivax has not been reported in Iran and it is used as a first-line treatment for P. vivax malaria. Conclusion: P. falciparum has become resistant to chloroquine in different regions of Iran and is not currently used to treat malaria. Besides, cases have emerged of P. falciparum resistance to SP in different parts of southern Iran, and SP is not administered alone for treating P. falciparum.

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