Evaluation of Plasmodium vivax malaria recurrence in Brazil
Autor: | Daher, André, Silva, Júlio C. A. L., Stevens, Antony, Marchesini, Paola, Fontes, C. J., Ter Kuile, F. O., Lalloo, David G. |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Falciparum
Adult Male Plasmodium lcsh:Arctic medicine. Tropical medicine Time Factors Adolescent lcsh:RC955-962 Vivax Primaquine Record link lcsh:Infectious and parasitic diseases Antimalarials Young Adult Recurrence Malaria Vivax Humans lcsh:RC109-216 Recurrences Child Aged Retrospective Studies Aged 80 and over Research Incidence Infant Newborn Infant Chloroquine Drug Synergism Middle Aged ACT Artemisinin-based combination therapy Artemisinins Malaria Child Preschool Drug Therapy Combination Female Brazil |
Zdroj: | Malaria Journal Malaria Journal, Vol 18, Iss 1, Pp 1-10 (2019) |
ISSN: | 1475-2875 |
Popis: | Background Control of vivax malaria in endemic areas requires management of recurrence. The Brazilian National Malaria Surveillance System (SIVEP-Malária) records every case of malaria in Brazil, but is not designed to differentiate between primary and recurrent infections. The aim of this study was to explore whether the information provided by SIVEP-Malária could be used to identify Plasmodium vivax recurrences, its risk factors and evaluate the effectiveness of short course primaquine (7–9 days: total dose 3–4.2 mg/kg) in preventing relapses. Methods In this observational retrospective cohort study, data matching of SIVEP-Malária records was undertaken using bloom filters to identify potential recurrences defined as microscopically-confirmed P. vivax episodes from the same individual occurring within a year. Generalized Estimation Equation (GEE) models were used to determine predictors of recurrence. Extended Cox-based conditional Prentice–Williams–Peterson models (PWP) models were used to evaluate time to recurrence. Results Between June 1, 2014 and May 31, 2015, 26,295 episodes fulfilled the criteria of potential recurrence among 154,970 reported malaria episodes. Age ≤ 3 years, being male, literate, not-indigenous and having domestic working activities were identified as risk factors for recurrence. There was no difference in time to recurrence or recurrence frequency between patients treated with 14-day or 7–9 day primaquine regimens (HR = 1.02, 0.96–1.09) and RR = 0.97 (0.90–1.04), respectively. The use of chloroquine alone was associated with a 1.43 (1.29–1.58, p 60 days, respectively. PWP models showed that the time to recurrence was longer in recipients of both primaquine and artemisinin-based combination therapy (ACT) compared to patients treated with chloroquine alone or with concomitant primaquine, HR = 2.2 (1.62–2.99, p |
Databáze: | OpenAIRE |
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