Emerging Plasmodium vivax resistance to chloroquine in South America: an overview

• Main Authors: Lígia Antunes Gonçalves, Pedro Cravo, Marcelo Urbano Ferreira
• Format: Article
• Language: English
• Published: Instituto Oswaldo Cruz, Ministério da Saúde 2014-08-01
• Series: Memórias do Instituto Oswaldo Cruz.
• Subjects: Plasmodium vivax; chloroquine; resistance; Latin America
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762014000500534&lng=en&tlng=en

The global emergence of Plasmodium vivax strains resistant to chloroquine (CQ) since the late 1980s is complicating the current international efforts for malaria control and elimination. Furthermore, CQ-resistant vivax malaria has already reached an alarming prevalence in Indonesia, East Timor and Papua New Guinea. More recently, in vivo studies have documented CQ-resistant P. vivax infections in Guyana, Peru and Brazil. Here, we summarise the available data on CQ resistance across P. vivax-endemic areas of Latin America by combining published in vivo and in vitro studies. We also review the current knowledge regarding the molecular mechanisms of CQ resistance in P. vivax and the prospects for developing and standardising reliable molecular markers of drug resistance. Finally, we discuss how the Worldwide Antimalarial Resistance Network, an international collaborative effort involving malaria experts from all continents, might contribute to the current regional efforts to map CQ-resistant vivax malaria in South America.