Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar
In Rakhine State, on the western border of Myanmar, the efficacy of chloroquine (CQ) and pyrimethamine/sulfadoxine (PS), the current treatments for uncomplicated Plasmodium falciparum malaria in this area, was evaluated in an open comparative study of 289 patients, stratified prospectively into 3 ag...
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th-mahidol.179982018-07-04T14:53:56Z Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar F. M. Smithuis F. Monti M. Grundl A. Zaw Oo T. T. Kyaw O. Phe N. J. White Arisen Zonder Grenzen Vector Borne Disease Control Mahidol University Nuffield Department of Clinical Medicine UNICEF Immunology and Microbiology Medicine In Rakhine State, on the western border of Myanmar, the efficacy of chloroquine (CQ) and pyrimethamine/sulfadoxine (PS), the current treatments for uncomplicated Plasmodium falciparum malaria in this area, was evaluated in an open comparative study of 289 patients, stratified prospectively into 3 age groups. Chloroquine treatment was associated with more rapid clinical recovery (P = 0.03), but the overall cure rates were worse than for PS treatment; failure to clear parasitaemia or recrudescence within 14 d occurred in 72% (102/141) of cases treated with CQ compared to 47% (69/148) of those who received PS (P < 0.0001, adjusted for age). Failure rates at day 28 increased to 82% (116/141) in the CQ group and 67% (99/148) in the PS group (P = 0.003). The risk of treatment failure was significantly higher in children under 15 years old than in adults for both CQ (relative risk [RR] = 2.6; 95% confidence interval [95% CI] 1.3-5.2) and PS (RR = 2.2; 95% CI 1.4-3.3). Mefloquine (15 mg base/kg) proved to be highly effective as a treatment for CQ and PS resistant P. falciparum; only 2 of 75 patients (3%) had early treatment failures (≤ day 7), and the overall failure rate by day 42 was 7%. There is a very high level of chloroquine and PS resistance in P. falciparum on the western border of Myanmar, but mefloquine was effective in the area. 2018-07-04T07:45:00Z 2018-07-04T07:45:00Z 1997-01-01 Article Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.91, No.4 (1997), 468-472 10.1016/S0035-9203(97)90288-1 00359203 2-s2.0-0030751387 https://repository.li.mahidol.ac.th/handle/123456789/17998 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0030751387&origin=inward |
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Immunology and Microbiology Medicine F. M. Smithuis F. Monti M. Grundl A. Zaw Oo T. T. Kyaw O. Phe N. J. White Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar |
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In Rakhine State, on the western border of Myanmar, the efficacy of chloroquine (CQ) and pyrimethamine/sulfadoxine (PS), the current treatments for uncomplicated Plasmodium falciparum malaria in this area, was evaluated in an open comparative study of 289 patients, stratified prospectively into 3 age groups. Chloroquine treatment was associated with more rapid clinical recovery (P = 0.03), but the overall cure rates were worse than for PS treatment; failure to clear parasitaemia or recrudescence within 14 d occurred in 72% (102/141) of cases treated with CQ compared to 47% (69/148) of those who received PS (P < 0.0001, adjusted for age). Failure rates at day 28 increased to 82% (116/141) in the CQ group and 67% (99/148) in the PS group (P = 0.003). The risk of treatment failure was significantly higher in children under 15 years old than in adults for both CQ (relative risk [RR] = 2.6; 95% confidence interval [95% CI] 1.3-5.2) and PS (RR = 2.2; 95% CI 1.4-3.3). Mefloquine (15 mg base/kg) proved to be highly effective as a treatment for CQ and PS resistant P. falciparum; only 2 of 75 patients (3%) had early treatment failures (≤ day 7), and the overall failure rate by day 42 was 7%. There is a very high level of chloroquine and PS resistance in P. falciparum on the western border of Myanmar, but mefloquine was effective in the area. |
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Arisen Zonder Grenzen |
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Arisen Zonder Grenzen F. M. Smithuis F. Monti M. Grundl A. Zaw Oo T. T. Kyaw O. Phe N. J. White |
format |
Article |
author |
F. M. Smithuis F. Monti M. Grundl A. Zaw Oo T. T. Kyaw O. Phe N. J. White |
author_sort |
F. M. Smithuis |
title |
Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar |
title_short |
Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar |
title_full |
Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar |
title_fullStr |
Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar |
title_full_unstemmed |
Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar |
title_sort |
plasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western myanmar |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/17998 |
_version_ |
1763490767964209152 |