Title
Resistance of infection by Plasmodium vivax to chloroquine in Bolivia
Date Issued
01 July 2015
Access level
open access
Resource Type
journal article
Author(s)
Añez A.
Moscoso M.
Laguna Á.
Garnica C.
Melgar V.
Cuba M.
Ascaso C.
Centro de Salud la Unidad
Publisher(s)
BioMed Central
Springer Nature
Abstract
Background: Chloroquine (CQ) over three days plus primaquine (PQ) for seven days is the treatment of choice of infections by Plasmodium vivax in Bolivia, where 95% of the cases of malaria are attributed to this species. The aim of this study was to evaluate the therapeutic efficacy of CQ in this setting. Methods: Patients in the Amazon region of northern Bolivia, were included in the study from May to November 2011 and the therapeutic efficacy of CQ was evaluated over a 28-day follow-up period. Patients with P. vivax mono-infection received 25 mg/Kg body weight of CQ over three days. The concentrations of CQ + desethylchloroquine (DCQ) in blood were determined at days 7 and 28 of follow up; at follow-up and on the day of treatment failure was administered PQ. Results: One hundred patients fulfilled the inclusion criteria, two were lost to follow up and another two were later excluded for protocol violation. Of the 96 patients who completed the follow up 10 showed TF; one presented continued parasitaemia until day 7 of follow up, three on day 21 and six on day 28 of follow up. The geometric mean of CQ + DCQ on day 7 was 321.7 ng/ml (range 197-535 ng/ml). In six patients with TF the CQ + DCQ concentrations in blood on the day of TF were >100 ng/ml. The rate of resistance was 6.5%. Conclusion: The present study demonstrates the presence of resistance to CQ in the treatment of malaria by P. vivax in the Amazon region of Bolivia. New clinical trials are needed to establish alternative treatments against these parasites in this region of South America.
Volume
14
Issue
1
Language
English
OCDE Knowledge area
Tecnología médica de laboratorio (análisis de muestras, tecnologías para el diagnóstico) Salud pública, Salud ambiental Medicina tropical
Scopus EID
2-s2.0-84948671907
PubMed ID
Source
Malaria Journal
ISSN of the container
14752875
Sponsor(s)
This study received financial support from the Iniciativa Amazónica contra la Malaria/Red Amazónica de la Vigilancia de las Drogas Antimaláricas AMI/ RAVREDA, supported by Ministry of Health of Bolivia, the board of the network of Riberalta and the Organización Panamericana de la Salud. We would like to thank all the patients who donated blood for the study as well as Mrs. Maritza Morales Technician. Angelo Roca, Fátima Tuno, Zulma Queteguari, Mrs. Sulfia, Paola Languide and Francisco Ramos, Jorge Castillo, and Dr. Jorge Cuba for their help in patient adherence to the study.
Sources of information: Directorio de Producción Científica Scopus