Steep Rebound of Chloroquine-Sensitive Plasmodium falciparum in Zimbabwe.

Affiliation

Mharakurwa S(1), Matsena-Zingoni Z(2), Mudare N(1), Matimba C(1), Gara TX(1), Makuwaza A(2), Maponga G(2), Munyati S(3), Gwanzura L(3)(4), Mutambu SL(1), Mason P(3), Kobayashi T(5)(6), Midzi N(2), Moss WJ(5)(6), Ippolito MM(6)(7).
Author information:
(1)Department of Health Sciences, Africa University, Mutare, Zimbabwe.
(2)National Institute of Health Research Malaria Section, Harare, Zimbabwe.
(3)Biomedical Research and Training Institute, Harare, Zimbabwe.
(4)College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
(5)Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
(6)Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
(7)Division of Clinical Pharmacology and Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Abstract

Removal of chloroquine from national malaria formularies can lead to the reversion of resistant Plasmodium falciparum to wild-type. We report a steep decline in chloroquine-resistant P falciparum within 10 years of national discontinuation of chloroquine monotherapy in Zimbabwe. Drug resistance surveillance is a vital component of malaria control programs, and the experience with chloroquine in Zimbabwe and elsewhere in sub-Saharan Africa is illustrative of the potentially rapid and dramatic impact of drug policy on antimalarial resistance.