Efficacy of chloroquine and primaquine for the treatment of uncomplicated plasmodium vivax malaria in Cruzeiro do Sul, Brazil

• Autor(a) principal: Negreiros, Suiane
• Data de Publicação: 2016
• Outros Autores: Farias, Sâmela, Viana, Giselle Maria Rachid, Okoth, Sheila Akinyi, Chenet, Stella M, Souza, Thayna Maria Holanda de, Marchesini, Paola, Udhayakumar, Venkatachalam, Póvoa, Marinete Marins, Santelli, Ana Carolina Faria e Silva, Oliveira, Alexandre Macedo de
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Digital do Instituto Evandro Chagas (Patuá)
• Texto Completo: https://patua.iec.gov.br/handle/iec/3154
• topic: Malária Vivax / farmacologia; Plasmodium vivax / efeitos de drogas; Antimaláricos / uso terapêutico; Cloroquina / uso terapêutico; Primaquina / uso terapêutico; Quimioterapia Combinada; Resultado do Tratamento; Repetições de Microssatélites; Técnicas de Genotipagem; Recidiva

We evaluated the efficacy of chloroquine and primaquine on uncomplicated Plasmodium vivax malaria in Cruzeiro do Sul, Brazil, in 2014. Patients ≥ 5 years of age with either fever or history of fever, and laboratoryconfirmed P. vivax monoinfection received chloroquine (total dose = 25 mg/kg) and primaquine (total dose = 3.5 mg/kg), and were followed up for 168 days (24 weeks). We used microsatellite genotyping to differentiate recurrent infections caused by heterologous parasites from those caused by homologous ones. No new P. vivax episode occurred by Day 28 among 119 enrolled patients, leading to Day 28, with adequate clinical and parasitological response (ACPR) of 100% (95% confidence interval [CI] = 96.7–100%). Twenty-eight P. vivax episodes occurred by Day 168, with uncorrected ACPR of 69.9% (95% CI = 59.5–79.0%). Fifteen of these episodes were caused by either homologous haplotypes or haplotypes that could not be determined. Excluding the 13 recurrent episodes caused by heterologous parasites, Day 168 microsatellite-corrected ACPR was estimated at 81.2% (95% CI = 71.0–89.1%). Chloroquine and primaquine remain efficacious to treat acute uncomplicated P. vivax infection, but moderate recurrence rates were observed within 24 weeks of follow-up.