Mefloquine-resistant strains of Plasmodium falciparum in Madagascar: impact on tourists and public health.

Although the national policy for malaria control in Madagascar is to use chloroquine as the first line of treatment, mefloquine has been and is recommended to travellers to the country, both for malaria prevention and cure. The in-vitro susceptibility of Plasmodium falciparum to mefloquine was therefore assessed during a prospective surveillance study in various areas in Madagascar, including the tourist sites of Nosy-be and Sainte Marie. Of the 254 isolates of P.

[Drug resistance of Plasmodium falciparum along the borders of the highlands in Madagascar: outlook for a national control program].

Resistance of Plasmodium falciparum to chloroquine was first suspected in Madagascar in 1975 and later confirmed in vivo and in vitro. During the period from 1985 and 1990, the network of public health monitoring stations reported that 1% of the population living on the central Highlands of Madagascar died of malaria. Thereafter the National Malaria Control Program achieved good success by spraying homes with insecticide and reorganizing distribution of chloroquine in all villages.

In vitro and in vivo chloroquine-potentiating action of Strychnos myrtoides alkaloids against chloroquine-resistant strains of Plasmodium malaria.

Crude alkaloids of Strychnos myrtoides Gilg & Busse, empirically used as an adjuvant to chloroquine (CQ) in Malagasy herbal remedies, were practically devoid of intrinsic in vitro and in vivo antimalarial activity. However, when combined with CQ at a dose level much lower than their IC50 value, they markedly enhanced in vitro the effectiveness of the synthetic drug against a CQ-resistant strain of Plasmodium falciparum. They also enhanced in vivo CQ activity against a resistant strain of Plasmodium yoelii.

In vitro antimalarial activity and chloroquine potentiating action of two bisbenzylisoquinoline enantiomer alkaloids isolated from Strychnopsis thouarsii and Spirospermum penduliflorum.

The bisbenzylisoquinolines 7-O-demethyltetrandrine and limacine, respectively, isolated from Strychnopsis thouarsii Baill. and Spirospermum penduliflorum Thou. were evaluated for their intrinsic antimalarial activity in vitro and chloroquine potentiating action against the chloroquine-resistant Plasmodium falciparum FCM 29 originating from Cameroon.