title: Malaria treatment policies and drug efficacy in Haiti from 1955-2012.
abstract: OBJECTIVE
  Chloroquine (CQ), after 67 years of use in Haiti, is still part of the official treatment policy for malaria. Several countries around the world have used CQ in the past due to its low incidence of adverse events, therapeutic efficacy, and affordability, but were forced to switch treatment policy due to the development of widespread CQ resistance. The purpose of this paper was to compile literature on malaria treatment policies and antimalarial drug efficacy in Haiti over 67-year period.
  
  
  METHODS
  A systematic review of PubMed, Web of Science, and the Armed Forces Pest Management Board, was conducted to find pertinent documents on national malaria treatment policies and antimalarial drug efficacy studies in Haiti between 1955 and 2012. A total of 329 citations and abstracts were reviewed independently by two researchers, of which thirty three met the final inclusion criteria of studies occurring in Haiti between 1955 and 2012 which specifically discuss malaria treatment policies and drug efficacy.
  
  
  RESULTS
  Results suggest that CQ has been the predominant antimalarial drug in use from 1955 to 2012. In 2010 single dose primaquine (PQ) was added to the national treatment policy, however it is not clear whether this new policy has been put into practice.
  
  
  CONCLUSIONS
  Although no widespread CQ resistance has been reported, some studies have detected low levels of CQ resistance. Increased surveillance and monitoring for CQ resistance should be implemented in Haiti.
authors.affiliation: Department of Environmental and Global Health, University of Florida, P.O. Box 100188, Gainesville, FL 32610, USA ; Emerging Pathogens Institute, University of Florida, P.O. Box 100009, Gainesville, FL 32610, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: von Fricken
authors.affiliation: Department of Environmental and Global Health, University of Florida, P.O. Box 100188, Gainesville, FL 32610, USA ; Emerging Pathogens Institute, University of Florida, P.O. Box 100009, Gainesville, FL 32610, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Weppelmann
authors.affiliation: Emerging Pathogens Institute, University of Florida, P.O. Box 100009, Gainesville, FL 32610, USA.
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Hosford
authors.affiliation: National Laboratory of Public Health, Ministry of Public Health and Sanitation, Angle Delmas 33 et Rue Charbonnieres, Haiti.
authors.forename: Alexander
authors.initials: A
authors.lastname: Existe
authors.affiliation: Department of Environmental and Global Health, University of Florida, P.O. Box 100188, Gainesville, FL 32610, USA ; Emerging Pathogens Institute, University of Florida, P.O. Box 100009, Gainesville, FL 32610, USA.
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Okech
keywords: Anti-malarial drug resistance; Chemotherapy; Chloroquine; Haiti; Hispaniola; Malaria treatment policy; Plasmodium falciparum; Pyrimethamine
references.citation: Lancet. 2010 Mar 27;375(9720):1067-9
references.pmid: 20352657
references.citation: Bull World Health Organ. 1987;65(3):339-44
references.pmid: 3311436
references.citation: Bull World Health Organ. 1984;62(4):623-6
references.pmid: 6386210
references.citation: Bull Pan Am Health Organ. 1988;22(1):92-103
references.pmid: 3382834
references.citation: Emerg Infect Dis. 2007 Oct;13(10):1494-6
references.pmid: 18257993
references.citation: Science. 2010 May 14;328(5980):850-1
references.pmid: 20466921
references.citation: Bull World Health Organ. 1985;63(3):585-92
references.pmid: 3899394
references.citation: Bull World Health Organ. 1983;61(6):1017-20
references.pmid: 6370485
references.citation: Emerg Infect Dis. 2009 May;15(5):735-40
references.pmid: 19402959
references.citation: Am J Trop Med Hyg. 2008 Feb;78(2):262-9
references.pmid: 18256427
references.citation: Am J Trop Med Hyg. 2012 Jan;86(1):29-31
references.pmid: 22232446
references.citation: Rev Panam Salud Publica. 1998 Jan;3(1):35-9
references.pmid: 9503961
references.citation: WHO Chron. 1978 Jan;32(1):9-17
references.pmid: 625958
references.citation: Bull World Health Organ. 1997;75(2):109-15
references.pmid: 9185362
references.citation: Am J Trop Med Hyg. 1975 Mar;24(2):199-205
references.pmid: 1091170
references.citation: J Am Mosq Control Assoc. 1986 Jun;2(2):150-3
references.pmid: 3507484
references.citation: MMWR Morb Mortal Wkly Rep. 2010 Mar 5;59(8):217-9
references.pmid: 20203553
references.citation: Bull Pan Am Health Organ. 1994 Mar;28(1):9-16
references.pmid: 8012437
references.citation: Am J Trop Med Hyg. 1986 May;35(3):459-64
references.pmid: 3518501
references.citation: Rev Panam Salud Publica. 2000 Mar;7(3):162-7
references.pmid: 10808749
references.citation: Emerg Infect Dis. 2012 Sep;18(9):1487-9
references.pmid: 22932030
references.citation: Bull Pan Am Health Organ. 1986;20(3):304-20
references.pmid: 3801747