Resistance of Plasmodium falcipanrm to chloroquine has been documented in most countries where there is transmission, over the last 2 decades (PETERS, 1987; PAYNE, 1989). Resistance to other antimalarials has followed in many countries. This article will focus on resistance occurring in chemotherapy rather than prophylaxis. Host factors, including pharmacokinetics and immunity, will not be reviewed.

The epidemiology of drug-resistant malaria.

Quinine (QN) remains effective against Plasmodium falciparum, but its decreasing efficacy is documented from different continents. Multiple genes are likely to contribute to the evolution of QN resistance. To locate genes contributing to QN response variation, we have searched a P. falciparum genetic cross for quantitative trait loci (QTL). Results identify additive QTL in segments of chromosomes (Chrs) 13, 7 and 5, and pairwise effects from two additional loci of Chrs 9 and 6 that interact, respectively, with the QTL of Chrs 13 and 7. The mapped segments of Chrs 7 and 5 contain pfcrt, the determinant of chloroquine resistance (CQR), and pfmdr1, a gene known to affect QN responses. Association of pfcrt with a QTL of QN resistance supports anecdotal evidence for an evolutionary relationship between CQR and reduced QN sensitivity. The Chr 13 segment contains several candidate genes, one of which (pfnhe-1) encodes a putative Na(+)/H(+) exchanger. A repeat polymorphism in pfnhe-1 shows significant association with low QN response in a collection of P. falciparum strains from Asia, Africa and Central and South America. Dissection of the genes and modifiers involved in QN response will require experimental strategies that can evaluate multiple genes from different chromosomes in combination.

/pdf/dissecting-the-loci-of-low-level-quinine-resistance-in-2fa13detjb.pdf

Dissecting the loci of low‐level quinine resistance in malaria parasites

The dynamics of drug resistance in Plasmodium falciparum

Chikungunya virus (CHIKV) emerged in the Americas in late 2013 to cause substantial acute and chronic morbidity. About 1.1 million cases of chikungunya were reported within a year, including severe cases and deaths. The burden of chikungunya is unclear owing to inadequate disease surveillance and underdiagnosis. Virus evolution, globalization, and climate change may further CHIKV spread. No approved vaccine or antiviral therapeutics exist. Early detection and appropriate management could reduce the burden of severe atypical and chronic arthritic disease. Improved surveillance and risk assessment are needed to mitigate the impact of chikungunya.

https://stacks.cdc.gov/view/cdc/43659/cdc_43659_DS1.pdf

Epidemiology of Chikungunya in the Americas.

The development and spread of drug-resistant malaria

Recommandations françaises pour la prise en charge du chikungunya . Simon a,∗, E. Javelle a, A. Cabie b, E. Bouquillard c, O. Troisgros d, G. Gentile e, I. Leparc-Goffart f, B. Hoen g, F. Gandjbakhch h, P. Rene-Corail d, J.-M. Franco i, E. Caumes j, B. Combe k, S. Poiraudeau l, F. Gane-Troplent m, F. Djossou n, T. Schaerverbeke o, A. Criquet-Hayot p, P. Carrere m, D. Malvy q, P. Gaillard i, D. Wendling r a Service de pathologie infectieuse et tropicale, hôpital d’instruction des Armées Laveran, 34, boulevard Alphonse-Laveran, CS 50004, 13384 Marseille cedex 13, France b Service de maladies infectieuses et tropicales, CHU de Fort-de-France, 97261 Fort-de-France, Martinique c Service de rhumatologie, CHU de Saint-Pierre, 97448 Saint-Pierre, Reunion d Service de médecine physique et réadaptation, CHU de Fort-de-France, 97261 Fort-de-France, Martinique e Département universitaire de médecine générale, faculté de médecine, université d’Aix-Marseille, 13005 Marseille, France f ERRIT-IRBA, HIA Laveran, centre national de référence des arboviroses, 13384 Marseille, France g Service de maladies infectieuses et tropicales, CHU de Pointe-à-Pitre, 97159 Pointe-à-Pitre, Guadeloupe h Service de rhumatologie, CHU Pitié-Salpêtrière, 75013 Paris, France i Département universitaire de médecine générale, université de la Réunion, 97490 Saint-Denis, Reunion j Service de maladies infectieuses et tropicales, CHU Pitié-Salpêtrière, 75013 Paris, France k Service de rhumatologie, CHU de Montpellier, Montpellier, France l Service de médecine physique et réadaptation, CHU de Cochin, 75014 Paris, France m Département universitaire de médecine générale, université des Antilles et de la Guyane, 97154 Pointe-à-Pitre, France n Service de maladies infectieuses et tropicales, centre hospitalier Andrée-Rosemon, 97306 Cayenne, Guyane o Service de rhumatologie, CHU Pellegrin, 33076 Bordeaux, France p Département universitaire de médecine générale, université des Antilles et de la Guyane, 97261 Fort-de-France, Martinique q Service de maladies infectieuses et tropicales, CHU Pellegrin, 97261 Bordeaux, France r Service de rhumatologie, CHU de Besançon, 25030 Besançon, France

French guidelines for the management of chikungunya (acute and persistent presentations). November 2014

Reduced sensitivity of Plasmodium falciparum to mefloquine in West Africa.

The members of the Palurea Study Group were provided in such a way that they could not be indexed as collaborators on PubMed. The publisher apologizes for this error and is pleased to list the members of the group here.

/pdf/imported-falciparum-malaria-in-adults-host-and-parasite-1fry3j30m0.pdf

Imported falciparum malaria in adults: host- and parasite-related factors associated with severity. The French prospective multicenter PALUREA cohort study.

Rift Valley Fever (RVF) is an emerging zoonotic arbovirus with a complex cycle of transmission that makes difficult the prediction of its expansion. Recent outbreaks outside Africa have led to rediscover the human disease but it remains poorly known. The wide spectrum of acute and delayed manifestations with potential unfavorable outcome much complicate the management of suspected cases and prediction of morbidity and mortality during an outbreak. We reviewed literature data on bio-clinical characteristics and treatments of RVF human illness. We identified gaps in the field and provided a practical algorithm to assist clinicians in the cases assessment, determination of setting of care and prolonged follow-up.

/pdf/the-challenging-management-of-rift-valley-fever-in-humans-lyubffn7fw.pdf

Fabrice Simon

Papers

French guidelines for the management of chikungunya (acute and persistent presentations). November 2014

Reduced sensitivity of Plasmodium falciparum to mefloquine in West Africa.

Imported falciparum malaria in adults: host- and parasite-related factors associated with severity. The French prospective multicenter PALUREA cohort study.

The challenging management of Rift Valley Fever in humans: literature review of the clinical disease and algorithm proposal.

Chikungunya Virus Infections.