Survival Probability of Plasmodium Falciparum against Chloroquine and its Combination with Sulphadoxine-Pyremethamine in Punjab, Pakistan

Abstract

Purpose of study: Survival probability of P.falciparum was determined against the chloroquine and its combination 
with sulphadoxine-pyremethamine. 
Type of study: Prospective nonrandomized descriptive study. 
Place and duration of study: Study was conducted in five districts “Muzaffargarh, D.G.Khan, Jhang, Sheikhupura 
and Multan” of Punjab, Pakistan. During the non-transmission season of the year 1999 to 2000 and 2008, among the 
rural populations 5952 persons were screened for malarial parasites. 
Methodology: During the malaria non transmission season (November, December & January), 5952 persons were 
screened for malaria and 1409 positive cases were detected. 404 subjects out of total positive cases were selected to 
be tested against chloroquine and 50 with combination of chloroquine and sulphadoxine-pyremethamine by in vivo 
technique. Follow up was carried out for 28 days (on day 1, 2, 3, 7, 14, 21 and 28).  
Result: Over all 35.4 % resistance-I was detected against chloroquine monotherapy and 4% with combination 
therapy (chloroquine and sulphadoxine-pyremethamine). Resistance-III was not found. Two variables were found 
important predictors of drug resistance; a young child and a high parasitaemia count (>6000/l) at day 0.  
Conclusion: It is concluded that malaria is still significant problem and resistance against monotherapy is 
increasing, hence adoption of combination therapy as first line treatment for uncomplicated falciparum malaria in 
Punjab Pakistan is recommended.