title: Slow clearance of Plasmodium vivax with chloroquine amongst children younger than six months of age in the Brazilian Amazon.
abstract: Plasmodium vivax is the most widespread parasite causing malaria, being especially prevalent in the Americas and Southeast Asia. Children are one of the most affected populations, especially in highly endemic areas. However, there are few studies evaluating the therapeutic response of infants with vivax malaria. This study retrospectively evaluated the parasitaemia clearance in children diagnosed with vivax malaria during the first five days of exclusive treatment with chloroquine (CQ). Infants aged less than six months old had a significantly slower parasitaemia clearance time compared to the group of infants and children between six months and 12 years old (Kaplan-Meier survival analysis; Wilcoxon test; p = 0.004). The impaired clearance of parasitaemia in younger children with vivax malaria is shown for the first time in Latin America. It is speculated that CQ pharmacokinetics in young children with vivax malaria is distinct, but this specific population may also allow the detection of CQ-resistant parasites during follow-up, due to the lack of previous immunity.
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: André M
authors.initials: AM
authors.lastname: Siqueira
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Lucas I
authors.initials: LI
authors.lastname: Coutinho
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Rafael L
authors.initials: RL
authors.lastname: Gurgel
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Willian C S
authors.initials: WC
authors.lastname: Su
authors.affiliation: Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil.
authors.forename: Luiz M
authors.initials: LM
authors.lastname: Carvalho
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Silvana G
authors.initials: SG
authors.lastname: Benzecry
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Aline C C
authors.initials: AC
authors.lastname: Alencar
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Márcia A A
authors.initials: MA
authors.lastname: Alexandre
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Maria Graças C
authors.initials: MG
authors.lastname: Alecrim
authors.affiliation: Universidade do Estado do Amazonas, Manaus, AM, Brasil.
authors.forename: Marcus V G
authors.initials: MV
authors.lastname: Lacerda
mesh_terms: D000367:Age Factors; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D018512:Parasitemia / Q000188:drug therapy* / Q000469:parasitology; D010966:Plasmodium vivax / Q000187:drug effects*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000962:Antimalarials; D002738:Chloroquine
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