Multiple drug resistant Plasmodium falciparum malaria in a pregnant indigenous Zambian woman.

A 24 year old Zambian female presented with falciparum malaria when 27 weeks pregnant. She had recently travelled to the copperbelt from Solwezi in the North-West Province of Zambia. Oral chloroquine in a dose of 29 mg/kg failed to clear the parasitaemia. Chloroquine resistance was confirmed by testing in vitro and in vivo. In addition, Fansidar (2 courses), amodiaquine, quinine and quinine plus erythromycin failed to achieve radical cure. Quinine resistance was confirmed in vitro and in vivo. She was eventually cured by 10 d of quinine plus clindamycin, which was greatly assisted by the spontaneous delivery of a live normal infant at 37 weeks gestation. The baby's birth weight was 2.68 kg and its blood slide was negative for malaria.