title: Efficacy of chloroquine for the treatment of Plasmodium vivax in the Saharan zone in Mauritania.
abstract: BACKGROUND
  In 2006, the Mauritanian Ministry of Health adopted a new therapeutic strategy based on the systematic use of artemisinin-based combination therapy (ACT), artesunate-amodiaquine and artemether-lumefantrine, for the first- and second-line treatment of uncomplicated malaria, respectively, regardless of Plasmodium spp. In the Saharan zone of the country, recent studies have shown that Plasmodium vivax largely predominates over Plasmodium falciparum. Anti-malarial drug response of P. vivax has not been evaluated in Mauritania. The aim of the present study was to evaluate the clinical efficacy and tolerance of chloroquine to treat P. vivax malaria in Mauritanian patients.
  
  
  METHODS
  Plasmodium vivax-infected patients aged > 6 months old were enrolled in Nouakchott and Atar in September-October 2013. Chloroquine was administered at the standard dose of 25 mg base/kg body weight over three days. Patients were followed until day 28, according to the standard 2009 World Health Organization protocol.
  
  
  RESULTS
  A total of 128 patients (67 in Nouakchott and 61 in Atar) were enrolled in the study. Seven patients (5.5%) were either excluded or lost to follow-up. Based on the per protocol analysis, chloroquine efficacy (adequate clinical and parasitological response) was 100%. Treatment was well-tolerated. One patient was excluded on day 1 due to urticaria and treated with artesunate-amodiaquine.
  
  
  CONCLUSIONS
  Although the current national treatment guideline recommends artesunate-amodiaquine for the first-line treatment of uncomplicated malaria, including P. vivax malaria, chloroquine may still have an important role to play in anti-malarial chemotherapy in Mauritania. Further epidemiological studies are required to map the distribution of P. vivax and P. falciparum in the country.
authors.affiliation: Unité de Recherche « Génome et Milieux », Faculté des Sciences et Techniques, Université des Sciences, de Technologie et de Médecine, Nouveau Campus Universitaire, Nouakchott, BP 5026, Mauritania. salem0606@yahoo.fr.
authors.forename: Mohamed Salem
authors.initials: MS
authors.lastname: Ould Ahmedou Salem
authors.forename: Yeslim Ould
authors.initials: YO
authors.lastname: Mohamed Lemine
authors.forename: Jemila Mint
authors.initials: JM
authors.lastname: Deida
authors.forename: Mohamed Aly Ould
authors.initials: MA
authors.lastname: Lemrabott
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ouldabdallahi
authors.forename: Mamadou Dit Dialaw
authors.initials: MD
authors.lastname: Ba
authors.forename: Ali Ould Mohamed Salem
authors.initials: AO
authors.lastname: Boukhary
authors.forename: Mohamed Lemine Ould
authors.initials: ML
authors.lastname: Khairy
authors.forename: Mohamed Boubacar
authors.initials: MB
authors.lastname: Abdel Aziz
authors.forename: Pascal
authors.initials: P
authors.lastname: Ringwald
authors.forename: Leonardo K
authors.initials: LK
authors.lastname: Basco
authors.forename: Saidou Doro
authors.initials: SD
authors.lastname: Niang
authors.forename: Sidi Mohamed
authors.initials: SM
authors.lastname: Lebatt
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000962:Antimalarials / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008435:Mauritania / Q000453:epidemiology; D008875:Middle Aged; D010966:Plasmodium vivax / Q000187:drug effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000962:Antimalarials; D002738:Chloroquine