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Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia

BACKGROUND: Plasmodium vivax accounts for about 44 % of all malaria infection in Ethiopia. Chloroquine (CQ) is the first-line treatment for vivax malaria in Ethiopia. Chloroquine-resistant (CQR) P. vivax has been emerging in different parts of the world to compromise the efficacy of the drug and pos...

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Autores principales: Assefa, Mesfin, Eshetu, Teferi, Biruksew, Abdissa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650862/
https://www.ncbi.nlm.nih.gov/pubmed/26577669
http://dx.doi.org/10.1186/s12936-015-0983-x
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author Assefa, Mesfin
Eshetu, Teferi
Biruksew, Abdissa
author_facet Assefa, Mesfin
Eshetu, Teferi
Biruksew, Abdissa
author_sort Assefa, Mesfin
collection PubMed
description BACKGROUND: Plasmodium vivax accounts for about 44 % of all malaria infection in Ethiopia. Chloroquine (CQ) is the first-line treatment for vivax malaria in Ethiopia. Chloroquine-resistant (CQR) P. vivax has been emerging in different parts of the world to compromise the efficacy of the drug and pose both health and economic impact in the developing world. The current study was aimed at assessing the therapeutic efficacy of CQ for the treatment of vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia. METHODS: A one-arm, 28-day follow-up, in vivo therapeutic efficacy study was conducted from 5 April to 25 June, 2014. Sixty-three patients aged between four and 59 years were enrolled with microscopically confirmed P. vivax infection. All patients were treated with CQ 25 mg/kg for 3 days. Recurrence of parasitaemia and clinical conditions of patients were assessed on days 1, 2, 3, 7, 14, 21, and 28 during the 28-day follow-up period. Haemoglobin (Hb) level was determined on day 0, day 28 and on day of recurrence of parasitaemia by using portable spectrophotometer. RESULTS: Of the total 63 patients included in the study, 60 (95.2 %) completed their 28-day follow-up; three patients were excluded from the study: one patient due to vomiting of the second dose of drug, one patient due to Plasmodium falciparum infection and one patient lost to follow-up during the study. During enrolment, 35 (53.3 %) had a history of fever and 28 (46.7 %) had documented fever. The geometric mean of parasite density on day of enrolment was 3472 parasites/μl. Among these, two patients had recurrent parasitaemia within the 28-day follow-up. CQ was found to be efficacious in 96.7 % of the study participants except two treatment failures detected. The failure might be due to late parasitological failure among these two patients who had recurrent parasitaemia within the 28-day follow-up. CONCLUSION: The current study revealed that CQ showed a high rate of efficacy (96.7 %) among the study participants even though some reports from previous studies elsewhere in Ethiopia showed an increase in CQR P. vivax. Thus, CQR molecular markers and regular monitoring of the pattern of resistance to CQ is needed for rapid and effective control measures of possible spread of drug resistance in the study area. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-015-0983-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-46508622015-11-19 Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia Assefa, Mesfin Eshetu, Teferi Biruksew, Abdissa Malar J Research BACKGROUND: Plasmodium vivax accounts for about 44 % of all malaria infection in Ethiopia. Chloroquine (CQ) is the first-line treatment for vivax malaria in Ethiopia. Chloroquine-resistant (CQR) P. vivax has been emerging in different parts of the world to compromise the efficacy of the drug and pose both health and economic impact in the developing world. The current study was aimed at assessing the therapeutic efficacy of CQ for the treatment of vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia. METHODS: A one-arm, 28-day follow-up, in vivo therapeutic efficacy study was conducted from 5 April to 25 June, 2014. Sixty-three patients aged between four and 59 years were enrolled with microscopically confirmed P. vivax infection. All patients were treated with CQ 25 mg/kg for 3 days. Recurrence of parasitaemia and clinical conditions of patients were assessed on days 1, 2, 3, 7, 14, 21, and 28 during the 28-day follow-up period. Haemoglobin (Hb) level was determined on day 0, day 28 and on day of recurrence of parasitaemia by using portable spectrophotometer. RESULTS: Of the total 63 patients included in the study, 60 (95.2 %) completed their 28-day follow-up; three patients were excluded from the study: one patient due to vomiting of the second dose of drug, one patient due to Plasmodium falciparum infection and one patient lost to follow-up during the study. During enrolment, 35 (53.3 %) had a history of fever and 28 (46.7 %) had documented fever. The geometric mean of parasite density on day of enrolment was 3472 parasites/μl. Among these, two patients had recurrent parasitaemia within the 28-day follow-up. CQ was found to be efficacious in 96.7 % of the study participants except two treatment failures detected. The failure might be due to late parasitological failure among these two patients who had recurrent parasitaemia within the 28-day follow-up. CONCLUSION: The current study revealed that CQ showed a high rate of efficacy (96.7 %) among the study participants even though some reports from previous studies elsewhere in Ethiopia showed an increase in CQR P. vivax. Thus, CQR molecular markers and regular monitoring of the pattern of resistance to CQ is needed for rapid and effective control measures of possible spread of drug resistance in the study area. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-015-0983-x) contains supplementary material, which is available to authorized users. BioMed Central 2015-11-17 /pmc/articles/PMC4650862/ /pubmed/26577669 http://dx.doi.org/10.1186/s12936-015-0983-x Text en © Assefa et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Assefa, Mesfin
Eshetu, Teferi
Biruksew, Abdissa
Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia
title Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia
title_full Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia
title_fullStr Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia
title_full_unstemmed Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia
title_short Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Hossana Health Care Centre, southern Ethiopia
title_sort therapeutic efficacy of chloroquine for the treatment of plasmodium vivax malaria among outpatients at hossana health care centre, southern ethiopia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650862/
https://www.ncbi.nlm.nih.gov/pubmed/26577669
http://dx.doi.org/10.1186/s12936-015-0983-x
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