Drug resistance is one of the principal obstacles blocking worldwide
malaria control. In
Colombia,
malaria remains a major
public health concern and
drug-resistant
parasites have been reported.
In vitro drug susceptibility assays are a useful tool for
monitoring the emergence and spread of
drug-resistant
Plasmodium falciparum. The present study was conducted as a proof of concept for an
antimalarial drug resistance
surveillance network based on
in vitro susceptibility testing in
Colombia. Sentinel
laboratories were set up in three
malaria endemic areas. The
enzyme linked immunosorbent assay-
histidine rich
protein 2 and
schizont maturation
methods were used to assess the susceptibility of fresh P. falciparum isolates to six
antimalarial drugs. This study demonstrates that an
antimalarial drug resistance
surveillance network based on
in vitro methods is feasible in the field with the participation of a
research institute, local
health institutions and
universities. It could also serve as a model for a regional
surveillance network. Preliminary susceptibility results showed widespread
chloroquine resistance, which was consistent with previous
reports for the Pacific region. However, high susceptibility to dihydroartemisinin and
lumefantrine compounds, currently used for
treatment in the country, was also reported. The implementation process identified critical points and opportunities for the improvement of network sustainability
strategies.