Antimalarial drug sensitivity test: A new approach toward management of severity of Plasmodium falciparum

Abstract

Background: Malaria despite everything represents a danger to the strength of occupants and voyagers in tropical nations. The Plasmodium species that are known to infect humans worldwide are Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi. Of these, P. falciparum causes high morbidity and mortality, and it is during the asexual erythrocytic stages that the majority of the indications of malaria are shown. Aim: The aim of this study was to standardize an in vitro assay for antimalarial drug sensitivity of P. falciparum isolates. Materials and Methods: This prospective study was carried out over a period of 1 year from July 2014 to June 2015. We effectively completed in vitro drug susceptibility testing on 34 isolates of P. falciparum, which were collected from the patient admitted in Mahatma Gandhi Mission’s Teaching Hospital, Navi Mumbai, Maharashtra, India. We obtained the P. falciparum 3D7 strain from Haffkine Institute for Training, Research and Testing, and Indian Institute of Technology (IIT) Bombay, Mumbai, Maharashtra, India. World Health Organization (WHO) standard in vitro micro-test (Mark III) method was used for the assessment of the response of P. falciparum to chloroquine, mefloquine, quinine, amodiaquine, sulfadoxine/pyrimethamine, and artemisinin. The method was partially modified by replacement of leukocytes with AB serum in Roswell Park Memorial Institute (RPMI)-1640 medium. Results: The development of P. falciparum 3D7 chloroquine-sensitive strain from the ring stage to schizonts (not fewer than six merozoites) in control wells containing chloroquine was 100% recorded. This level of development in the control wells empowered fast minute assurance (5min for isolate per drug) of the Minimum inhibitory concentrations (MICs) of chloroquine. The test well shows the development from the ring stage to mature schizont stages were 67.65% in well containing chloroquine, 17.65% in well containing amodiaquine, and 14.71% in well containing sulfadoxine/pyrimethamine, it means these drugs are resistant to P. falciparum, and however, there is no development of the P. falciparum from the ring stage to mature schizont (with at least six merozoites) stage in the well containing artesunate, mefloquine and quinine were equal to the control well, it means these antimalarial drugs are sensitive to the P. falciparum. Conclusion: Antimalarial drug resistance has developed as a result of prescribing this medication without having malaria. Early diagnosis of malaria and drug sensitivity testing may prevent the emergence of resistance to antimalarial drugs. Monotherapy ought to be kept up a key decent way from; the combined antimalarial drug therapy may reduce the chances of emergence of antimalarial drug resistance.