Resistance of infection by Plasmodium vivax to chloroquine in Bolivia
| Autor: | Mauren Cuba, Manuel Moscoso, Cecilia Garnica, Carlos Ascaso, Viviana Melgar, Sonia Gutierrez, Arletta Añez, Ángel Laguna |
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| Jazyk: | angličtina |
| Předmět: |
Adult
Male medicine.medical_specialty Bolivia Primaquine Adolescent Plasmodium vivax Drug Resistance Drug resistance Pharmacology Antimalarials Young Adult Chloroquine Internal medicine parasitic diseases medicine Malaria Vivax Humans Treatment Failure Lost to follow-up Child Aged biology business.industry Research Middle Aged biology.organism_classification medicine.disease Infectious Diseases Parasitology Child Preschool Tropical medicine Female Antimalarial drugs business Malaria medicine.drug |
| Zdroj: | Malaria Journal Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
| ISSN: | 1475-2875 |
| DOI: | 10.1186/s12936-015-0774-4 |
| Popis: | Background Chloroquine (CQ) over three days plus primaquine (PQ) for seven days is the treatment of choice of infections by Plasmodium vivax in Bolivia, where 95% of the cases of malaria are attributed to this species. The aim of this study was to evaluate the therapeutic efficacy of CQ in this setting. Methods Patients in the Amazon region of northern Bolivia, were included in the study from May to November 2011 and the therapeutic efficacy of CQ was evaluated over a 28-day follow-up period. Patients with P. vivax mono-infection received 25 mg/Kg body weight of CQ over three days. The concentrations of CQ + desethylchloroquine (DCQ) in blood were determined at days 7 and 28 of follow up; at follow-up and on the day of treatment failure was administered PQ. Results One hundred patients fulfilled the inclusion criteria, two were lost to follow up and another two were later excluded for protocol violation. Of the 96 patients who completed the follow up 10 showed TF; one presented continued parasitaemia until day 7 of follow up, three on day 21 and six on day 28 of follow up. The geometric mean of CQ + DCQ on day 7 was 321.7 ng/ml (range 197–535 ng/ml). In six patients with TF the CQ + DCQ concentrations in blood on the day of TF were >100 ng/ml. The rate of resistance was 6.5%. Conclusion The present study demonstrates the presence of resistance to CQ in the treatment of malaria by P. vivax in the Amazon region of Bolivia. New clinical trials are needed to establish alternative treatments against these parasites in this region of South America. |
| Databáze: | OpenAIRE |
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