Publication: In vivo sensitivity monitoring of chloroquine for the treatment of uncomplicated vivax malaria in four bordered provinces of Thailand during 2009-2010
Issued Date
2011-12-01
Resource Type
ISSN
09729062
Other identifier(s)
2-s2.0-84855901463
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Vector Borne Diseases. Vol.48, No.4 (2011), 190-196
Suggested Citation
Kanungnit Congpuong, Wichai Satimai, Anupong Sujariyakul, Somchai Intanakom, Warunee Harnpitakpong, Yuttana Pranuth, Sawad Cholpol, Pongwit Bualombai In vivo sensitivity monitoring of chloroquine for the treatment of uncomplicated vivax malaria in four bordered provinces of Thailand during 2009-2010. Journal of Vector Borne Diseases. Vol.48, No.4 (2011), 190-196. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/11963
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Title
In vivo sensitivity monitoring of chloroquine for the treatment of uncomplicated vivax malaria in four bordered provinces of Thailand during 2009-2010
Abstract
Background & objectives: Chloroquine (CQ), followed by 14-day primaquine, is the recommended regimen for the treatment of Plasmodium vivax infection in Thailand. CQ resistant P. vivax (CRPv) has not yet challenged the efficacy of the drug. The present study was conducted to assess the current response of P. vivax to CQ alone in Thailand. Methods: A 28-day in vivo therapeutic efficacy study was conducted from June 2009 to December 2010 in 4 sentinel sites. Recurrence of parasitaemia and the clinical condition of patients were assessed on each visit during follow-up. The drug levels in recurrent patients' blood were measured using HPLC. Data were analyzed using the WHO 2008 program for the analysis of in vivo tests. Results: Of the total 212 patients included in the study, 201 completed the 28-days follow-up, while 11 were excluded. In five patients (2.5%), parasitaemia reappeared within the 28-days follow-up. On the day of recurrent parasitaemia, the level of chloroquine/desethylchloroquine (CQ-DCQ) was above the minimum effective concentration (≥100 ng/ml) in one patient, but lower in four patients. Conclusion: Reappearance of the parasite within 28 days of follow-up in one of five patients was due to parasite resistance to CQ. The 2.5% prevalence of CQ treatment failure for P. vivax malaria in the study areas signals the need to launch monitoring activities for CQ resistant P. vivax in malaria endemic areas in order to detect further development of parasite resistance and to estimate the level of burden across the country.