Chloroquine has shown high therapeutic efficacy against uncomplicated Plasmodium vivax malaria in southern Ethiopia: seven decades after its introduction.

Autor: Mare AK; Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia., Mohammed H; Malaria and Other Parasitic Diseases Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Sime H; Malaria and Other Parasitic Diseases Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Hailgiorgis H; Malaria and Other Parasitic Diseases Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Gubae K; Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia., Gidey B; Malaria and Other Parasitic Diseases Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Haile M; Ethiopian Ministry of Health, Addis Ababa, Ethiopia., Assefa G; Ethiopian Ministry of Health, Addis Ababa, Ethiopia., Bekele W; World Health Organization, Addis Ababa, Ethiopia., Auburn S; Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia., Price R; Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia., Parr JB; Institute of Infectious Disease and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, USA., Juliano JJ; Institute of Infectious Disease and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, USA., Tasew G; Malaria and Other Parasitic Diseases Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Abay SM; Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia. Solomon.mequanente@aau.edu.et., Assefa A; Malaria and Other Parasitic Diseases Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Institute of Infectious Disease and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Jazyk: angličtina
Zdroj: Malaria journal [Malar J] 2024 Jun 10; Vol. 23 (1), pp. 183. Date of Electronic Publication: 2024 Jun 10.
DOI: 10.1186/s12936-024-05009-7
Abstrakt: Background: Plasmodium vivax malaria is a leading cause of morbidity in Ethiopia. The first-line treatment for P. vivax is chloroquine (CQ) and primaquine (PQ), but there have been local reports of CQ resistance. A clinical study was conducted to determine the efficacy of CQ for the treatment of P. vivax malaria in southern Ethiopia.
Methods: In 2021, patients with P. vivax mono-infection and uncomplicated malaria were enrolled and treated with 25 mg/kg CQ for 3 consecutive days. Patients were followed for 28 days according to WHO guidelines. The data were analysed using per-protocol (PP) and Kaplan‒Meier (K‒M) analyses to estimate the risk of recurrent P. vivax parasitaemia on day 28.
Results: A total of 88 patients were enrolled, 78 (88.6%) of whom completed the 28 days of follow-up. Overall, 76 (97.4%) patients had adequate clinical and parasitological responses, and two patients had late parasitological failures. The initial therapeutic response was rapid, with 100% clearance of asexual parasitaemia within 48 h.
Conclusion: Despite previous reports of declining chloroquine efficacy against P. vivax, CQ retains high therapeutic efficacy in southern Ethiopia, supporting the current national treatment guidelines. Ongoing clinical monitoring of CQ efficacy supported by advanced molecular methods is warranted to inform national surveillance and ensure optimal treatment guidelines.
(© 2024. The Author(s).)
Databáze: MEDLINE
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