Recurrence ofPlasmodium falciparumafter treatment with quinine and doxycycline in the Amazon basin

Autor: Margarete do Socorro Mendonça Gomes, Álvaro Augusto Ribeiro D'Almeida Couto, Vanja Suely Calvosa D’Almeida Couto, José Luiz Fernandes Vieira, Francis Christian da Silva Pereira, Ricado Luiz Dantas Machado, Michelle Valeria Dias Ferreira Vieira
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Drug Resistance
Gastroenterology
Brasil / epidemiologia
Doxiciclina / uso terap?utico
Antimal?ricos / uso terap?utico
Doxiciclina / farmacologia
0302 clinical medicine
Quinina / uso terap?utico
Recurrence
Parasite hosting
Malaria
Falciparum
Doxycycline
Quinine
biology
Quimioterapia Combinada
Infectious Diseases
Antimal?ricos / administra??o & dosagem
Drug Therapy
Combination
Female
Clearance rate
Brazil
Amazon basin
medicine.drug
Adult
medicine.medical_specialty
Plasmodium falciparum
030106 microbiology
030231 tropical medicine
Antimalarials
Young Adult
03 medical and health sciences
Internal medicine
parasitic diseases
medicine
Animals
Humans
Quinina / farmacologia
Mal?ria Falciparum / microbiologia
Retrospective Studies
Mal?ria Falciparum / quimioterapia
Plasmodium falciparum / efeitos de drogas
Public Health
Environmental and Occupational Health
Retrospective cohort study
biology.organism_classification
medicine.disease
Surgery
Antimal?ricos / farmacologia
Doxiciclina / administra??o & dosagem
Resist?ncia a Medicamentos
Estudos Retrospectivos
Parasitology
Quinina / administra??o & dosagem
Malaria
Recidiva
Zdroj: Repositório Digital do Instituto Evandro Chagas (Patuá)
Instituto Evandro Chagas (IEC)
instacron:IEC
ISSN: 1360-2276
DOI: 10.1111/tmi.12813
Popis: Central Laboratory of Public Health of Amap?. Macap?, AP, Brazil. Par? Federal University. Bel?m, PA, Brazil. Par? Federal University. Bel?m, PA, Brazil. Amap? State Health Department. Macap?, AP, Brazil. Par? Federal University. Bel?m, PA, Brazil. Par? Federal University. Bel?m, PA, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Objective: To investigate whether the recurrence of infection by Plasmodium falciparum in patients from the Brazilian Amazon was caused by an inadequate exposure to quinine. Methods: A retrospective study was carried out using blood samples from patients with slide-confirmed infection by P. falciparum, classified according to the parasitological response after 28 days of follow-up. Quinine and doxycycline were measured in plasma samples by high-performance liquid chromatography. A statistical model was used to estimate parasite clearance rates. Results: Six of 40 patients who met the criteria for inclusion in the study showed recurrence of parasitaemia within 28 days after the commencement of treatment. A group of six patients with adequate parasitological response was formed to avoid bias when the variables were compared. Parasitaemia at admission was similar in both groups. Plasma quinine concentrations were similar in both groups on days 1, 2 and 3 and ranged from 1.07 to 4.35 ?g/ml in cured patients and from 1.1 to 3.2 ?g/ml in patients with parasite recurrence. Concentrations of doxycycline were similar in both groups on day 3. The parasite clearance rate constant was 0.131 ? 0.16 h in the cured patients and 0.117 ? 0.02 h in those showing recurrence. The slope half-life in the cured patients was 4.8 h and 5.4 h in recurrence cases. The hillslope of the cured group (14.24) increased sharply compared to the recurrence group (4.13). Conclusion: There is evidence of a decreased in vivo sensitivity to quinine of P. falciparum strains in the Brazilian Amazon basin
Databáze: OpenAIRE
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