Chloroquine Resistance in a Case with Uncomplicated Plasmodium vivax Malaria: An Evolving Threat
Ganesh Kasinathan *
Department of Internal Medicine, Segamat Hospital, KM 6 Jalan Genuang, Segamat, Johor, Malaysia
*Author to whom correspondence should be addressed.
Abstract
Introduction: Chloroquine resistance is an emerging phenomenon in uncomplicated Plasmodium vivaxmalaria.
Presentation of Case: This case report describes a 21 year old forest worker who was diagnosed to have Plasmodium vivax malaria on blood film microscopy and it was confirmed on molecular real-time polymerase chain reaction analysis. He was treated with conventional oral chloroquine of optimal dosage in which he failed to respond appropriately. His blood film parasite count increased on day 3 of treatment despite adequate chloroquine therapy. He was then commenced on oral artemether-lumefantrine (Riamet) combination therapy in which he responded clinically and microscopically. He was discharged from the hospital after completing a 14-day course of oral primaquine. His serial blood films were negative for more than three consecutive days whilst in hospital. On subsequent weekly follow ups at the specialist clinic for a duration of 28 days, his blood films remained negative for malaria parasites.
Conclusion: Chloroquine resistance is now an emerging threat in many middle and low income countries globally.
Keywords: Chloroquine, malaria, Plasmodium vivax, hospital, microscopy