Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , |
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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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 |
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Fundação Oswaldo Cruz (FIOCRUZ) |
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Repositório Institucional da FIOCRUZ (ARCA) |
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