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Title: Characterization of "Yaa Chud" medicine on the Thailand-Myanmar border: Selecting for drug-resistant malaria and threatening public health
Authors: Paul N. Newton
Christina Y. Hampton
Krystyn Alter-Hall
Thanongsak Teerwarakulpana
Sompol Prakongpan
Ronnatrai Ruangveerayuth
Nicholas J. White
Nicholas P.J. Day
Mabel B. Tudino
Natalia Mancuso
Facundo M. Fernández
Mahosot Hospital
Georgia Institute of Technology
University of Oxford
Mae Sot General Hospital
Mahidol University
Universidad de Buenos Aires
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Nov-2008
Citation: American Journal of Tropical Medicine and Hygiene. Vol.79, No.5 (2008), 662-669
Abstract: Multidrug-resistant Plasmodium falciparum malaria is a severe public health problem on the Thailand-Myanmar border. Many villagers buy packets of 4-5 mixed medicines ("yaa chud") from shops without medical assessment as their first-line malaria treatment. In 2000-2001 a local researcher purchased 50 yaa chud from 44 shops around Mae Sot, Thailand and Myawaddy, Myanmar (Burma), for his wife who was said to be pregnant with fever and drowsiness. The tablets/capsules were provisionally identified by appearance and active ingredients determined in a subset by using mass and atomic spectrometry. The most frequently detected active ingredients were acetaminophen (22%), chlorpheniramine (13.4%), chloroquine (12.6%), tetracycline/doxycycline (11.4%), and quinine (5.1%). Only seven bags contained potentially curative medicine for malaria. A total of 82% of the bags contained medicines contraindicated in pregnancy. Inappropriate, ineffective antimalarial drugs on the Thailand-Myanmar border are likely to increase malaria morbidity, mortality and health costs and engender the emergence and spread of antimalarial drug resistance. Copyright © 2008 by The American Society of Tropical Medicine and Hygiene.
ISSN: 00029637
Appears in Collections:Scopus 2006-2010

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