Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil

Detalhes bibliográficos
Autor(a) principal: Andrade, Simone Ladeia
Data de Publicação: 2019
Outros Autores: Menezes, Maria José, Sousa, Taís Nóbrega de, Silvino, Ana Carolina Rios, Carvalho Junior, Jaques F. de, Salla, Laís Camonese, Nery, Odaílton A., Melo, Gladson N. P. de, Corder, Rodrigo M., Rodrigues, Priscila Thihara, Ferreira, Marcelo U.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/35084
Resumo: 2019-08-26
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spelling Andrade, Simone LadeiaMenezes, Maria JoséSousa, Taís Nóbrega deSilvino, Ana Carolina RiosCarvalho Junior, Jaques F. deSalla, Laís CamoneseNery, Odaílton A.Melo, Gladson N. P. deCorder, Rodrigo M.Rodrigues, Priscila ThiharaFerreira, Marcelo U.2019-08-26T19:32:53Z2019-08-26T19:32:53Z2019ANDRADE, Simone Ladeia et al. Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil. Antimicrobial Agents and Chemotherapy, v. 63, n. 5, p. 1-14, 2019.0066-4804https://www.arca.fiocruz.br/handle/icict/3508410.1128/AAC.01965-18engAmerican Society for MicrobiologyMonitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2019-08-26Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Doenças Parasitárias. Rio de Janeiro, RJ, BrazilUniversidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Malária. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Malária. Belo Horizonte, MG, Brasil.Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.Emerging Plasmodium vivax resistance to chloroquine (CQ) may undermine malaria elimination efforts in South America. CQ-resistant P. vivax has been found in the major port city of Manaus but not in the main malaria hot spots across the Amazon Basin of Brazil, where CQ is routinely coadministered with primaquine (PQ) for radical cure of vivax malaria. Here we randomly assigned 204 uncomplicated vivax malaria patients from Juruá Valley, northwestern Brazil, to receive either sequential (arm 1) or concomitant (arm 2) CQ-PQ treatment. Because PQ may synergize the blood schizontocidal effect of CQ and mask low-level CQ resistance, we monitored CQ-only efficacy in arm 1 subjects, who had PQ administered only at the end of the 28-day follow-up. We found adequate clinical and parasitological responses in all subjects assigned to arm 2. However, 2.2% of arm 1 patients had microscopy-detected parasite recrudescences at day 28. When PCR-detected parasitemias at day 28 were considered, response rates decreased to 92.1% and 98.8% in arms 1 and 2, respectively. Therapeutic CQ levels were documented in 6 of 8 recurrences, consistent with true CQ resistance in vivo In contrast, ex vivo assays provided no evidence of CQ resistance in 49 local P. vivax isolates analyzed. CQ-PQ coadministration was not found to potentiate the antirelapse efficacy of PQ over 180 days of surveillance; however, we suggest that larger studies are needed to examine whether and how CQ-PQ interactions, e.g., CQ-mediated inhibition of PQ metabolism, modulate radical cure efficacy in different P. vivax-infected populations. (This study has been registered at ClinicalTrials.gov under identifier NCT02691910.).AmazonBrazilPlasmodium vivaxChloroquineEfficacyMalariaPrimaquineinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83082https://www.arca.fiocruz.br/bitstream/icict/35084/1/license.txt9193a7c197bc67acd023525e72a03240MD51ORIGINALmonitoring.pdfmonitoring.pdfapplication/pdf314186https://www.arca.fiocruz.br/bitstream/icict/35084/2/monitoring.pdfdf3dd1cddd53663838cf7bb21e4de2f0MD52TEXTmonitoring.pdf.txtmonitoring.pdf.txtExtracted texttext/plain74547https://www.arca.fiocruz.br/bitstream/icict/35084/3/monitoring.pdf.txtc34d7ec4dbb589fe2383df7f8cf3f94eMD53icict/350842021-03-24 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dc.title.pt_BR.fl_str_mv Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
title Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
spellingShingle Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
Andrade, Simone Ladeia
Amazon
Brazil
Plasmodium vivax
Chloroquine
Efficacy
Malaria
Primaquine
title_short Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
title_full Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
title_fullStr Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
title_full_unstemmed Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
title_sort Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
author Andrade, Simone Ladeia
author_facet Andrade, Simone Ladeia
Menezes, Maria José
Sousa, Taís Nóbrega de
Silvino, Ana Carolina Rios
Carvalho Junior, Jaques F. de
Salla, Laís Camonese
Nery, Odaílton A.
Melo, Gladson N. P. de
Corder, Rodrigo M.
Rodrigues, Priscila Thihara
Ferreira, Marcelo U.
author_role author
author2 Menezes, Maria José
Sousa, Taís Nóbrega de
Silvino, Ana Carolina Rios
Carvalho Junior, Jaques F. de
Salla, Laís Camonese
Nery, Odaílton A.
Melo, Gladson N. P. de
Corder, Rodrigo M.
Rodrigues, Priscila Thihara
Ferreira, Marcelo U.
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Andrade, Simone Ladeia
Menezes, Maria José
Sousa, Taís Nóbrega de
Silvino, Ana Carolina Rios
Carvalho Junior, Jaques F. de
Salla, Laís Camonese
Nery, Odaílton A.
Melo, Gladson N. P. de
Corder, Rodrigo M.
Rodrigues, Priscila Thihara
Ferreira, Marcelo U.
dc.subject.en.pt_BR.fl_str_mv Amazon
Brazil
Plasmodium vivax
Chloroquine
Efficacy
Malaria
Primaquine
topic Amazon
Brazil
Plasmodium vivax
Chloroquine
Efficacy
Malaria
Primaquine
description 2019-08-26
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-08-26T19:32:53Z
dc.date.available.fl_str_mv 2019-08-26T19:32:53Z
dc.date.issued.fl_str_mv 2019
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv ANDRADE, Simone Ladeia et al. Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil. Antimicrobial Agents and Chemotherapy, v. 63, n. 5, p. 1-14, 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/35084
dc.identifier.issn.pt_BR.fl_str_mv 0066-4804
dc.identifier.doi.none.fl_str_mv 10.1128/AAC.01965-18
identifier_str_mv ANDRADE, Simone Ladeia et al. Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil. Antimicrobial Agents and Chemotherapy, v. 63, n. 5, p. 1-14, 2019.
0066-4804
10.1128/AAC.01965-18
url https://www.arca.fiocruz.br/handle/icict/35084
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv American Society for Microbiology
publisher.none.fl_str_mv American Society for Microbiology
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/35084/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/35084/2/monitoring.pdf
https://www.arca.fiocruz.br/bitstream/icict/35084/3/monitoring.pdf.txt
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
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