TY - JOUR
T1 - Therapeutic assessment of chloroquine-primaquine combined regimen in adult cohort of Plasmodium vivax malaria from a tertiary care hospital in southwestern India
AU - Rishikesh, Kumar
AU - Kamath, Asha
AU - Hande, Manjunatha H.
AU - Vidyasagar, Sudha
AU - Acharya, Raviraja V.
AU - Acharya, Vasudeva
AU - Belle, Jayaprakash
AU - Shastry, Ananthakrishna B.
AU - Saravu, Kavitha
N1 - Funding Information:
This study was supported by an extramural research grant (AMR/46/2011-ECD-I) from the Indian Council of Medical Research, New Delhi, India. The funding council had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors are immensely grateful to all the participants’of this study. The operational support of Mr Sathish Kitta Madivala and Mr Prashantha Prabhu, Laboratory Assistants of the aforementioned project grant are thankfully acknowledged.
Publisher Copyright:
© 2015 Rishikesh et al.
PY - 2015/8/11
Y1 - 2015/8/11
N2 - Background: Of late there have been accounts of therapeutic failure and chloroquine resistance in Plasmodium vivax malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine-primaquine (CQ-PQ) combined regimen in a cohort of uncomplicated P. vivax mono-infection. Methods: A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection P. vivax malaria as per the World Health Organization's protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks. Results: Of a total of 125 participants recruited, 122 (97.6%) completed day 28 follow up, three (2.4%) participants were lost to follow-up. Eight patients (6.4%) were ascertained to have mixed P. vivax and Plasmodium falciparum infection by nested polymerase chain reaction test. The majority of subjects (56.8%, 71/125) became aparasitaemic on day 2 followed by 35.2% (44/125) on day 3, and 8% (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8%, 1/125) occurred on day 3 due to persistence of fever and parasitaemia. Conclusions: CQ-PQ combined regimen remains outstandingly effective for uncomplicated P. vivax malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.
AB - Background: Of late there have been accounts of therapeutic failure and chloroquine resistance in Plasmodium vivax malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine-primaquine (CQ-PQ) combined regimen in a cohort of uncomplicated P. vivax mono-infection. Methods: A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection P. vivax malaria as per the World Health Organization's protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks. Results: Of a total of 125 participants recruited, 122 (97.6%) completed day 28 follow up, three (2.4%) participants were lost to follow-up. Eight patients (6.4%) were ascertained to have mixed P. vivax and Plasmodium falciparum infection by nested polymerase chain reaction test. The majority of subjects (56.8%, 71/125) became aparasitaemic on day 2 followed by 35.2% (44/125) on day 3, and 8% (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8%, 1/125) occurred on day 3 due to persistence of fever and parasitaemia. Conclusions: CQ-PQ combined regimen remains outstandingly effective for uncomplicated P. vivax malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.
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U2 - 10.1186/s12936-015-0824-y
DO - 10.1186/s12936-015-0824-y
M3 - Article
C2 - 26259839
AN - SCOPUS:84938862043
SN - 1475-2875
VL - 14
JO - Malaria Journal
JF - Malaria Journal
IS - 1
M1 - 310
ER -