One of these ways consists of reacting 3-chloroaniline with ethoxymethylenmalonic ester to make (3-choroanilino)-methylenemalonic ester (220.127.116.11), which then undergoes high-temperature heterocyclization to make the ethyl ester of 7-chloro-4-hydroxyquinolin-3-carboxylic acid (18.104.22.168). Hydrolyzing this with sodium hydroxide gives 7-chloro-4-hydroxyquinolin-3-decarboxylic acid (22.214.171.124), which when heated at 250–270 C is decarboxylated, forming 7-chloro-4-hydroxyquinoline (126.96.36.199). Hydroxychloroquine lab monitoring Chloroquine retinal screening Does hydroxychloroquine affect menstrual cycle Advil with plaquenil Chloroquine-resistant P. vivax malaria was first identified in 1989 among Australians living in or traveling to Papua New Guinea. P. vivax resistance to chloroquine has also now been identified in Southeast Asia, Ethiopia, and Madagascar. Isolated reports have suggested chloroquine-resistance P. vivax in other countries and regions, but further evaluation is needed. The results indicated that chloroquine-resistant falciparum malaria was present in all eight provinces/autonomous regions endemic for falciparum malaria in China, and the resistance was high and widely distributed in the Hainan and Yunnan provinces. The results indicated that falciparum malaria highly resistant to chloroquine was present in Hainan and Yunnan provinces, and falciarum malaria in southern Guangxi and central Anhui also exhibited obvious chloroquine resistance, but the resistance level in these latter two provinces was lower than that in Hainan and Yunnan, and the chloroquine resistance in southern Henan, Guizhou, and western Jiangsu was at its initial stage see Table 1. Alkaline hydrolysis of the ethyl ester of the 7-chloro-4-hydroxyquinolin-2-carboxylic acid (188.8.131.52) and subsequent high-temperature decarboxylation of the resulting acid (184.108.40.206) gives 7-chloro-4-hydroxyquinolin (220.127.116.11). Treating this with phosphorus oxychloride gives one of the desired components for synthesis of chloroquine – 4,7-dichloroquinoline (18.104.22.168) [The second method of preparing of 4,7-dichloroquinoline (22.214.171.124) consists of reacting 3-chloroaniline with the diethyl ester of oxaloacetic acid in the presence of acetic acid to give the corresponding enamine (126.96.36.199), which when heated to 250 °C undergoes heterocyclization to the ethyl ester of 7-chloro-4-hydrozyquinolin-2-carboxylic acid (188.8.131.52) accompanied with a small amount of 5-chloro-4-hydroxyquinolin-2-carboxylic acid (184.108.40.206), which is separated from the main product by crystallization from acetic acid. Chloroquine resistance in china Chloroquine - Wikipedia, Surveillance of antimalarial drug resistance in China in the. Plaquenil side effects long termDoes plaquenil help with inflammation Chloroquine-resistant forms of Plasmodium falciparum malaria first appeared in Thailand in 1957 see map. They then spread through South and Southeast Asia and by the 1970s were being seen in sub. The Origins of Antimalarial-Drug Resistance NEJM. Surveillance of antimalarial drug resistance in China in.. Could an old malaria drug help fight the new coronavirus?. Chloroquine-resistant P. falciparum first developed independently in three to four areas in Southeast Asia, Oceania, and South America in the late 1950s and early 1960s. Since then, chloroquine resistance has spread to nearly all areas of the world where falciparum malaria is transmitted. Chloroquine Nivaquine, Resochin, and; Ritonavir; Chloroquine was the first drug that was used as an effective treatment for malaria infection. It was discovered in China and the tree from which it was derived was used over years for medicinal purposes. Over time, its use has declined because of the emergence of chloroquine-resistant organisms. Conclude that chloroquine resistance has spread across most countries endemic for P vivax. However, China, a region historically endemic for malaria, was ignored. The first reports of the resistance of P vivax to chloroquine in China date back to the 1980s.