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Mounting reasons for a chloroquine comeback?

By Sungano Mharakurwa Moderator | 19 Jan, 2017

The former safest, most effective and affordable antimalarial drug chloroquine appears a promising anticancer drug (See (http://kdvr.com/2017/01/18/malaria-drug-successfuly-used-to-fight-brain-cance... and also 'Anticancer' attachment). What is more, chloroquine antimalarial efficacy is returning in many areas with high malaria transmission (see 'Antimal' attachments). With increasing cancers also in malaria-endemic areas, should the return of chloroquine be advocated or is it still early?
By the way, chloroquine is also apparently effective against Chikungunya, another febrile illness that abounds in malarious areas (see CQ_antiChikungunya).

Replies

 

Pierre Bush, PhD Moderator Replied at 2:04 PM, 19 Jan 2017

Thank you Sungano for starting this discussion, and providing these informative resources. Indeed there is growing evidence of the return of Chloroquine-sensitive Plasmodium falciparum in several malaria endemic areas. It is a very good development. Since its development by Andersag in 1934, Chloroquine (first named Resochin) was the best malaria drug treatment till its semi-demise in the late 20th century. Unfortunately a study completed in Ethiopia reported that as there is a return of chloroquine sensitive Plasmodium falciparum, there is also some resistance developed by P. vivax. We have to watch both developments.

Attached resources:

Maimunat Alex-Adeomi Moderator Replied at 11:02 AM, 24 Jan 2017

Thank you Pierre and Sungano for the attached articles on Chloroquine (CQ)-sensitive and resistant malaria. I agree that with increasing "resistance" to ACT in some malaria endemic areas, clinicians and other health care workers have gone back to the use of CQ and there have been mixed reviews about this. The positive though is that it does still work for the most part and it is very cost effective.

Sungano Mharakurwa Moderator Replied at 3:53 PM, 25 Jan 2017

Thanks Maimunat for those thoughts. It took four decades for chloroquine resistance to emerge, after the drug presumably saved millions of lives. Resistant parasites have largely disappeared within about ten years of suspending drug use. However, there has been current fear that resistant parasites might reappear rapidly this time upon reintroduction of chloroquine. Has there been field evidence for this, let alone when chloroquine is used with a partner drug? What is also interesting is a recent demonstration (attached) that chloroquine-resistant malaria is successfully treated by a double dose regimen of chloroquine that is still well tolerated.

Attached resource:

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