title: Efficacy of Chloroquine and Primaquine for the Treatment of Uncomplicated Plasmodium vivax Malaria in Cruzeiro do Sul, Brazil.
abstract: We evaluated the efficacy of chloroquine and primaquine on uncomplicated Plasmodium vivax malaria in Cruzeiro do Sul, Brazil, in 2014. Patients ≥ 5 years of age with either fever or history of fever, and laboratory-confirmed P. vivax monoinfection received chloroquine (total dose = 25 mg/kg) and primaquine (total dose = 3.5 mg/kg), and were followed up for 168 days (24 weeks). We used microsatellite genotyping to differentiate recurrent infections caused by heterologous parasites from those caused by homologous ones. No new P. vivax episode occurred by Day 28 among 119 enrolled patients, leading to Day 28, with adequate clinical and parasitological response (ACPR) of 100% (95% confidence interval [CI] = 96.7-100%). Twenty-eight P. vivax episodes occurred by Day 168, with uncorrected ACPR of 69.9% (95% CI = 59.5-79.0%). Fifteen of these episodes were caused by either homologous haplotypes or haplotypes that could not be determined. Excluding the 13 recurrent episodes caused by heterologous parasites, Day 168 microsatellite-corrected ACPR was estimated at 81.2% (95% CI = 71.0-89.1%). Chloroquine and primaquine remain efficacious to treat acute uncomplicated P. vivax infection, but moderate recurrence rates were observed within 24 weeks of follow-up.
authors.affiliation: Acre State Health Secretariat, Acre State, Brazil.
authors.forename: Suiane
authors.initials: S
authors.lastname: Negreiros
authors.affiliation: Acre State Health Secretariat, Acre State, Brazil.
authors.forename: Samela
authors.initials: S
authors.lastname: Farias
authors.affiliation: Instituto Evandro Chagas, Brazilian Ministry of Health, Ananindeua, Brazil.
authors.forename: Giselle Maria Rachid
authors.initials: GM
authors.lastname: Viana
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.|Atlanta Research and Education Foundation, Decatur, Georgia.
authors.forename: Sheila Akinyi
authors.initials: SA
authors.lastname: Okoth
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Stella M
authors.initials: SM
authors.lastname: Chenet
authors.affiliation: Acre State Health Secretariat, Acre State, Brazil.
authors.forename: Thayna Maria Holanda
authors.initials: TM
authors.lastname: de Souza
authors.affiliation: National Malaria Control Program, Brazilian Ministry of Health, Brasilia, Brazil.
authors.forename: Paola
authors.initials: P
authors.lastname: Marchesini
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Venkatachalam
authors.initials: V
authors.lastname: Udhayakumar
authors.affiliation: Instituto Evandro Chagas, Brazilian Ministry of Health, Ananindeua, Brazil.
authors.forename: Marinete Marins
authors.initials: MM
authors.lastname: Povoa
authors.affiliation: National Malaria Control Program, Brazilian Ministry of Health, Brasilia, Brazil.
authors.forename: Ana Carolina Faria E Silva
authors.initials: AC
authors.lastname: Santelli
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia. acq7@cdc.gov.
authors.forename: Alexandre Macedo
authors.initials: AM
authors.lastname: de Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D060005:Genotyping Techniques; D006801:Humans; D016780:Malaria, Vivax / Q000188:drug therapy*; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D010966:Plasmodium vivax / Q000187:drug effects; D011319:Primaquine / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000962:Antimalarials; D002738:Chloroquine; D011319:Primaquine