A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil

Detalhes bibliográficos
Autor(a) principal: Andrade, João Guimarães de
Data de Publicação: 1992
Outros Autores: Andrade, Ana Lúcia Sampaio Sgambatti de, Araujo, Elisabeth S. O., Oliveira, Renato Maurício, Silva, Simonne Almeida, Martelli, Celina Maria Turchi, Zicker, Fábio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista do Instituto de Medicina Tropical de São Paulo
Texto Completo: https://www.revistas.usp.br/rimtsp/article/view/28968
Resumo: This clinical trial compared parasitological efficacy, levels of in vivo resistance and side effects of oral chloroquine 25 mg/Kg and 50 mg/Kg in 3 days treatment in Plasmodium falciparum malaria with an extended followed-up of 30 days. The study enroled 58 patients in the 25 mg/Kg group and 66 in the 50 mg/Kg group. All eligible subjects were over 14 years of age and came from Amazon Basin and Central Brazil during the period of August 1989 to April 1991. The cure rate in the 50 mg/Kg group was 89.4% on day 7 and 71.2% on day 14 compared to 44.8% and 24.1% in the 25 mg/Kg group. 74.1% of the patients in the 25 mg/Kg group and 48.4% of the patients in the 50 mg/Kg group had detectable parasitaemia at the day 30. However, there was a decrease of the geometric mean parasite density in both groups specially in the 50 mg/Kg group. There was 24.1% of RIII and 13.8% of RH in the 25 mg/Kg group. Side effects were found to be minimum in both groups. The present data support that there was a high level resistance to chloroquine in both groups, and the high dose regimen only delayed the development of resistance and its administration should not be recommended as first choice in malaria P. falciparum therapy in Brazil.
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spelling A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil Ensaio clínico aleatório duplo cego com cloroquina em dose alta para tratamento da malária por Plasmodium falciparum no Brasil MalariaPlasmodium falciparumChloroquineClinical trial This clinical trial compared parasitological efficacy, levels of in vivo resistance and side effects of oral chloroquine 25 mg/Kg and 50 mg/Kg in 3 days treatment in Plasmodium falciparum malaria with an extended followed-up of 30 days. The study enroled 58 patients in the 25 mg/Kg group and 66 in the 50 mg/Kg group. All eligible subjects were over 14 years of age and came from Amazon Basin and Central Brazil during the period of August 1989 to April 1991. The cure rate in the 50 mg/Kg group was 89.4% on day 7 and 71.2% on day 14 compared to 44.8% and 24.1% in the 25 mg/Kg group. 74.1% of the patients in the 25 mg/Kg group and 48.4% of the patients in the 50 mg/Kg group had detectable parasitaemia at the day 30. However, there was a decrease of the geometric mean parasite density in both groups specially in the 50 mg/Kg group. There was 24.1% of RIII and 13.8% of RH in the 25 mg/Kg group. Side effects were found to be minimum in both groups. The present data support that there was a high level resistance to chloroquine in both groups, and the high dose regimen only delayed the development of resistance and its administration should not be recommended as first choice in malaria P. falciparum therapy in Brazil. Comparou-se a eficácia parasitológica, níveis de resistência "in vivo" e efeitos colaterais da cloroquina oral nas dosagens de 25 mg/kg e 50 mg/kg no tratamento da malária por Plasmodium falciparum com seguimento de 30 dias. O estudo foi conduzido de agosto de 1989 a abril de 1991 e incluiu 124 pacientes, selecionados aleatoriamente em blocos de 10 pacientes, do ambulatório da Fundação Nacional de Saúde-Goiânia, Brasil. Todos os pacientes eram procedentes da Bacia Amazônica e Brasil - Central, sendo 58 alocados no grupo de 25 mg/kg (C25) e 66 no grupo de 50 mg/kg (C50). Os efeitos colaterais foram mínimos em ambos os grupos. A taxa de cura no C50 foi 89,4% no dia 7 e 71,2% no dia 14 enquanto para o C25 as taxas foram de 44,8% e 24,1%, respectivamente. Setenta e quatro por cento dos pacientes do C25 e 48,4% no C50 apresentaram parasitemia detectável no dia 30. Entretanto, houve uma queda da média geométrica da densidade parasitária (MGDP) em ambos os grupos, especialmente no C50. Resistência tipo III e II foi detectada respectivamente em 24,1% e 13,8% dos pacientes no grupo C25. No grupo de 50 mg/kg não foi detectado nenhum caso de RII registrando-se apenas um caso de RIII. Um grande número de RI tardio foi detectado em ambos os grupos, o que poderia retardar o tempo de portador e contribuir para disseminação de cepas resistentes. Desta forma, o presente estudo conclui que cloroquina, em qualquer das doses testadas, não deve ser utilizada no tratamento da malária por P. falciparum, em nosso meio. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo1992-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/28968Revista do Instituto de Medicina Tropical de São Paulo; Vol. 34 No. 5 (1992); 467-473 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 34 Núm. 5 (1992); 467-473 Revista do Instituto de Medicina Tropical de São Paulo; v. 34 n. 5 (1992); 467-473 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/28968/30825Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessAndrade, João Guimarães deAndrade, Ana Lúcia Sampaio Sgambatti deAraujo, Elisabeth S. O.Oliveira, Renato MaurícioSilva, Simonne AlmeidaMartelli, Celina Maria TurchiZicker, Fábio2012-07-02T01:33:46Zoai:revistas.usp.br:article/28968Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:50:43.919007Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true
dc.title.none.fl_str_mv A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
Ensaio clínico aleatório duplo cego com cloroquina em dose alta para tratamento da malária por Plasmodium falciparum no Brasil
title A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
spellingShingle A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
Andrade, João Guimarães de
Malaria
Plasmodium falciparum
Chloroquine
Clinical trial
title_short A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
title_full A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
title_fullStr A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
title_full_unstemmed A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
title_sort A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil
author Andrade, João Guimarães de
author_facet Andrade, João Guimarães de
Andrade, Ana Lúcia Sampaio Sgambatti de
Araujo, Elisabeth S. O.
Oliveira, Renato Maurício
Silva, Simonne Almeida
Martelli, Celina Maria Turchi
Zicker, Fábio
author_role author
author2 Andrade, Ana Lúcia Sampaio Sgambatti de
Araujo, Elisabeth S. O.
Oliveira, Renato Maurício
Silva, Simonne Almeida
Martelli, Celina Maria Turchi
Zicker, Fábio
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Andrade, João Guimarães de
Andrade, Ana Lúcia Sampaio Sgambatti de
Araujo, Elisabeth S. O.
Oliveira, Renato Maurício
Silva, Simonne Almeida
Martelli, Celina Maria Turchi
Zicker, Fábio
dc.subject.por.fl_str_mv Malaria
Plasmodium falciparum
Chloroquine
Clinical trial
topic Malaria
Plasmodium falciparum
Chloroquine
Clinical trial
description This clinical trial compared parasitological efficacy, levels of in vivo resistance and side effects of oral chloroquine 25 mg/Kg and 50 mg/Kg in 3 days treatment in Plasmodium falciparum malaria with an extended followed-up of 30 days. The study enroled 58 patients in the 25 mg/Kg group and 66 in the 50 mg/Kg group. All eligible subjects were over 14 years of age and came from Amazon Basin and Central Brazil during the period of August 1989 to April 1991. The cure rate in the 50 mg/Kg group was 89.4% on day 7 and 71.2% on day 14 compared to 44.8% and 24.1% in the 25 mg/Kg group. 74.1% of the patients in the 25 mg/Kg group and 48.4% of the patients in the 50 mg/Kg group had detectable parasitaemia at the day 30. However, there was a decrease of the geometric mean parasite density in both groups specially in the 50 mg/Kg group. There was 24.1% of RIII and 13.8% of RH in the 25 mg/Kg group. Side effects were found to be minimum in both groups. The present data support that there was a high level resistance to chloroquine in both groups, and the high dose regimen only delayed the development of resistance and its administration should not be recommended as first choice in malaria P. falciparum therapy in Brazil.
publishDate 1992
dc.date.none.fl_str_mv 1992-10-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/28968
url https://www.revistas.usp.br/rimtsp/article/view/28968
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/28968/30825
dc.rights.driver.fl_str_mv Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
dc.source.none.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo; Vol. 34 No. 5 (1992); 467-473
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 34 Núm. 5 (1992); 467-473
Revista do Instituto de Medicina Tropical de São Paulo; v. 34 n. 5 (1992); 467-473
1678-9946
0036-4665
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reponame_str Revista do Instituto de Medicina Tropical de São Paulo
collection Revista do Instituto de Medicina Tropical de São Paulo
repository.name.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)
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