Plasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar.

Hdl Handle:
http://hdl.handle.net/10144/17730
Title:
Plasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar.
Authors:
Smithuis, F; Monti, F; Grundl, M; Oo, A Z; Kyaw, T T; Phe, O; White, N J
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
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 (< or = 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.
Affiliation:
Artsen Zonder Grenzen, Médecins Sans Frontières-Holland, Yangon, Myanmar, Thailand.
Publisher:
Elsevier
Issue Date:
7-Feb-2008
URI:
http://hdl.handle.net/10144/17730
PubMed ID:
9373658
Additional Links:
http://www.sciencedirect.com/science/journal/00359203
Language:
en
ISSN:
0035-9203
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorSmithuis, F-
dc.contributor.authorMonti, F-
dc.contributor.authorGrundl, M-
dc.contributor.authorOo, A Z-
dc.contributor.authorKyaw, T T-
dc.contributor.authorPhe, O-
dc.contributor.authorWhite, N J-
dc.date.accessioned2008-02-07T16:58:23Z-
dc.date.available2008-02-07T16:58:23Z-
dc.date.issued2008-02-07T16:58:23Z-
dc.identifier.citationPlasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar., 91 (4):468-72 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid9373658-
dc.identifier.urihttp://hdl.handle.net/10144/17730-
dc.description.abstractIn 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 (< or = 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.en
dc.language.isoenen
dc.publisherElsevier-
dc.relation.urlhttp://www.sciencedirect.com/science/journal/00359203-
dc.rightsArchived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.aspen
dc.subject.meshAdulten
dc.subject.meshAntimalarialsen
dc.subject.meshChild, Preschoolen
dc.subject.meshChloroquineen
dc.subject.meshDrug Therapy, Combinationen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMalaria, Falciparumen
dc.subject.meshMaleen
dc.subject.meshMyanmaren
dc.subject.meshProspective Studiesen
dc.subject.meshPyrimethamineen
dc.subject.meshSulfadoxineen
dc.subject.meshTime Factorsen
dc.subject.meshTreatment Outcomeen
dc.titlePlasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar.en
dc.contributor.departmentArtsen Zonder Grenzen, Médecins Sans Frontières-Holland, Yangon, Myanmar, Thailand.en
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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