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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/17998
Title: Plasmodium falciparum: Sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar
Authors: 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
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-1997
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.91, No.4 (1997), 468-472
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 (≤ 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.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0030751387&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/17998
ISSN: 00359203
Appears in Collections:Scopus 1991-2000

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