[Plasmodium vivax malaria: treatment of primary attacks with primaquine, in three different doses, and a fixed dose of chloroquine, Antioquia, Colombia, 2003-2004].
BACKGROUND
Chloroquine (CQ) and primaquine (PQ) are used in Colombia for treatment of uncomplicated vivax malaria but there are few efficacy studies of this scheme.


OBJECTIVE
(a) to investigate the clinical picture of vivax malaria in adult patients; (b) to evaluate the antimalarial treatment response to the standard scheme CQ-PQ; (c) to compare the efficacy of the standard scheme and two alternative schemes with equal dose of CQ and different PQ dose; (d) to identify the adverse effects of CQ-PQ treatment.


METHODS
Randomized, nonblind design; three groups, defined according to total dose of PQ: 45, 105 and 210 mg. All patients received CQ (1500 mg, in 48 hours), which was followed by PQ. Patients were recruited in Turbo and El Bagre. The follow-up period was 28 days. Antimalarial treatment response was classified according to the WHO-2001 protocol (early failure, late failure, adequate response).


RESULTS
In total 228 patients were recruited, 18 were lost between days 4 and 27; the antimalarial treatment response was evaluated in 210. The clinical findings were similar to those described by other authors. Parasitaemia clearance was confirmed during the first 24 hours of CQ treatment in 11% of patients. At 48 hours 66% and at 72 hours 97% of patients were negative. All patients (210) displayed adequate treatment response to the CQ-PQ treatment. The different doses of PQ did not affect this response.


CONCLUSIONS
CQ-PQ should be conserved as the first treatment choice and should be evaluated in other areas. Simultaneous administration of CQ and PQ is proposed.
Carmona-Fonseca
Jaime
J
Grupo de Malaria, Universidad de Antioquia, Medellín, Colombia. jaime.carmonaf@hotmail.com
Alvarez
Gonzalo
G
D000208:Acute Disease; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D002738:Chloroquine / Q000008:administration & dosage* / Q000009:adverse effects; D003105:Colombia; D005260:Female; D006801:Humans; D016780:Malaria, Vivax / Q000188:drug therapy*; D008297:Male; D011319:Primaquine / Q000008:administration & dosage* / Q000009:adverse effects
D000962:Antimalarials; D002738:Chloroquine; D011319:Primaquine