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Therapeutic response of multidrug-resistant Plasmodium falciparum and P. vivax to chloroquine and sulfadoxine-pyrimethamine in southern Papua, Indonesia

Ratcliff, A., Siswantoro, H., Kenangalem, Enny, Wuwung, M., Brockman, Alan, Edstein, M., Laihad, F., Ebsworth, E., Anstey, Nicholas M., Tjitra, E. and Price, Ric N. (2007). Therapeutic response of multidrug-resistant Plasmodium falciparum and P. vivax to chloroquine and sulfadoxine-pyrimethamine in southern Papua, Indonesia. Transactions of the Royal Society of Tropical Medicine and Hygiene,101(4):351-359.

Document type: Journal Article
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IRMA ID 10002xPUB36
Title Therapeutic response of multidrug-resistant Plasmodium falciparum and P. vivax to chloroquine and sulfadoxine-pyrimethamine in southern Papua, Indonesia
Author Ratcliff, A.
Siswantoro, H.
Kenangalem, Enny
Wuwung, M.
Brockman, Alan
Edstein, M.
Laihad, F.
Ebsworth, E.
Anstey, Nicholas M.
Tjitra, E.
Price, Ric N.
Journal Name Transactions of the Royal Society of Tropical Medicine and Hygiene
Publication Date 2007
Volume Number 101
Issue Number 4
ISSN 0035-9203   (check CDU catalogue open catalogue search in new window)
Start Page 351
End Page 359
Total Pages 9
Place of Publication UK
Publisher Elsevier
HERDC Category C1 - Journal Article (DEST)
Abstract To determine the level of antimatarial drug resistance in southern Papua, Indonesia, we assessed the therapeutic efficacy of chloroquine plus sulfadoxine-pyrimethamine (CQ+SP) for Plasmodium falciparum infections as welt as CQ monotherapy for P. vivox infections. Patients with P. falciparum failing therapy were re-treated with unsupervised quinine+/-doxycyctine therapy and those with P. vivax with either unsupervised quinine+/-doxycycline or amodiaquine. In total, 143 patients were enrolled in the study (103 treated with CQ+SP and 40 with CQ). Early treatment failures occurred in four patients (4%) with P. falciparum and six patients (15%) with P. vivox. The failure rate by Day 28 for P. vivax was 65% (95% CI 49-81). After PCR correction for re-infections, the Day 42 recrudescence rate for P. falciparum infections was 48% (95% CI 31-65). Re-treatment with unsupervised quinine+/-doxycycline resulted in further recurrence of malaria in 48% (95% CI 31-65) of P. falciparum infections and 70% (95% CI 37-100) of P. vivox infections. Eleven patients with recurrent P. vivox were retreated with amodiaquine; there were no early or late treatment failures. In southern Papua, a high prevalence of drug resistance of P. falciparum and P. vivox exists both to first- and second-line therapies. Preliminary data indicate that amodiaquine retains superior efficacy compared with CQ for CQ-resistant P. vivox. (C) 2006 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
Keywords malaria
Plasmodium falciparum
Plasmodium vivax
chloroquine
sulfadoxine-pyrimethamine
drug resistance
Papua
Indonesia
irian jaya
artesuna
primaquine
quinine
DOI http://dx.doi.org/10.1016/j.trstmh.2006.06.008   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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