UGANDA

 
Published: Friday 15 October 1999

A recent study reveals that up to one-third of malaria parasites in Kampala are resistant to chloroquine and quinine, Uganda's first-line treatment for malaria. The study conducted by L N Mutanda, head of the Central Public Health Laboratory in Kampala, shows that resistance to other drugs is also rising.

The study shows that 27 per cent of the Plasmodium falciparum parasites are resistant to chloroquine, while 26 per cent are resistant to quinine. Health experts say the rising resistance to cheap anti-malarials among parasites could precipitate epidemics such as those seen in Kenya, which this year alone have killed more than 1,000 people around the Lake Victoria region. Resistance to cheap anti-malarials, mainly caused by improper use of medicines, including taking insufficient doses or failing to complete a treatment course, may also push the cost of treatment beyond the reach of most Ugandans, leading to higher mortality levels.

Mutanda says that in addition to single drug resistance, significant numbers of malaria parasites are developing double or multiple drug resistance. The highest level of double drug resistance, at 21 per cent, was observed in patients who had taken chloroquine and quinine, suggesting cross-resistance to the two drugs, the report says.

Similarly, the highest level of multi-drug resistance, was observed in patients who had taken chloroquine and fansider. Metakelfin and fansider are used in Uganda as second-line treatments for malaria. Countries situated in the Horn of Africa region have reported high incidence of drug resistance by malaria parasite.

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