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Chloroquine efficacy for Plasmodium vivax malaria treatment in southern Ethiopia

Getachew, Sisay, Ley-Thriemer, Kamala, Auburn, Sarah, Abera, Adugna, Gadisa, Endalamaw, Aseffa, Abraham, Price, Ric N. and Petros, Beyene (2015). Chloroquine efficacy for Plasmodium vivax malaria treatment in southern Ethiopia. Malaria Journal,14(Article No. 525).

Document type: Journal Article
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IRMA ID 10444xPUB36
Title Chloroquine efficacy for Plasmodium vivax malaria treatment in southern Ethiopia
Author Getachew, Sisay
Ley-Thriemer, Kamala
Auburn, Sarah
Abera, Adugna
Gadisa, Endalamaw
Aseffa, Abraham
Price, Ric N.
Petros, Beyene
Journal Name Malaria Journal
Publication Date 2015
Volume Number 14
Issue Number Article No. 525
ISSN 1475-2875   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84951844229
Total Pages 8
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Chloroquine (CQ) is the first-line treatment for vivax malaria in Ethiopia, but there is evidence for its declining efficacy. Defining the extent and regional distribution of CQ resistance is critical to ensure optimal treatment guidelines. This study aimed to provide data on the therapeutic efficacy of CQ against Plasmodium vivax malaria in southern Ethiopia.

Methods
Patients with P. vivax mono-infection aged between 8 months and 65 years were enrolled in a clinical efficacy trial. The study was conducted at four sites in southern Ethiopia. Study participants were treated with a supervised course of CQ (25 mg/kg over three consecutive days), followed by weekly blood film examination and clinical assessment for 28 days. CQ blood concentrations were not assessed. The primary endpoint was the risk of failure at 28 days by survival analysis.

Results

Between May 2010 and December 2013, 288 patients were enrolled in the study (n = 89 in Shele, n = 52 in Guba, n = 57 in Batu and n = 90 in Shone). Baseline characteristics varied significantly between sites. In total 34 (11.8 %) patients were censored during follow up (five with Plasmodium falciparum parasitaemia and 29 lost to follow up). Two (0.7 %) patients experienced early treatment failure and 23 (8 %) late treatment failure. The overall risk of recurrence by day 28 was 9.4 % (95 % CI 6.4–13.6 %) with site-specific estimates of 3.8 % (95 % CI 1.2–11.3) for Shele, 21.9 % (95 % CI 12.2–36.1) for Guba, 5.9 % (95 % CI 1.9–17.3) for Batu and 9.2 % (95 % CI 4.5–17.6) for Shone.

Conclusion
There is evidence of reduced CQ efficacy across three of the four study sites, with the degree of resistance severe enough in Guba to suggest that review of treatment policy may be warranted.
Keywords Malaria
Vivax
Chloroquine
Ethiopia
Resistance
DOI http://dx.doi.org/10.1186/s12936-015-1041-4   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au


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