title: Therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients at Shawa Robit Health Care Centre, North-East Ethiopia.
abstract: Nearly 40% of all malaria infection in Ethiopia is caused by Plasmodium vivax. Chloroquine (CQ) is the first line treatment for confirmed P. vivax malaria in the country. However, the efficacy of this drug has been compromised by CQ resistant P. vivax (CRPv) strains. Therefore, the present study was aimed at assessing the therapeutic efficacy of CQ for treatment of P. vivax malaria at Shawa Robit Health Care Centre, North-Ease Ethiopia. A one-arm, 28-day follow-up, in vivo therapeutic efficacy study was conducted from October 2013 to February 2014. Eighty-seven patients with microscopically confirmed P. vivax mono - infection aged between 1 and 65 years were enrolled and treated with a 25mg/kg CQ administered for three consecutive days under supervision. Socio-demographic and clinical information were collected. Blood smears were prepared and examined for parasite clearance or recurrence of parasitaemia. Clinical examination was performed at all follow-up visits. Haematocrit determination was made. Percentages, frequencies, Kaplan-Meier survival probability analysis and statistical associations were computed. P-value of <0.05 was considered statistically significant. From the total 87 patients included in the study 76 (87.4%) completed their 28-day follow-up; four patients were excluded due to P. falciparum infection during the follow up (on day 2, day 7 and day 14) and seven cases were lost to follow-up (on day 3, day 7 and day 14). Among those P. vivax infected individuals, 44 (50.6%) subjects were febrile on day of admission and the remaining had history of fever. From the 76 study participants who completed the 28-day follow up period, late parasitological failure (LPF) was observed in five (6.6%) cases. The geometric mean of parasite density was 8723.9/μl and mean haematocrit value was 35.45%. Besides, survival analysis showed that the cumulative incidence of success and failure rates at day 28 was 93.4% (95% CI=0.849-0.972) and 7.04% (95% CI=0.028-0.151), respectively. The current study unveils possible emergence of CRPv malaria in the study area. Regular and periodic evaluation of the efficacy of CQ should be conducted to monitor the spread of CRPv strains.
authors.affiliation: Jigjiga Health Science College, Somali Regional State, Ethiopia. Electronic address: sebleseifu21@gmail.com.
authors.forename: Seble
authors.initials: S
authors.lastname: Seifu
authors.affiliation: Jimma University, School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia. Electronic address: ahmed.zeynudin@ju.edu.et.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Zeynudin
authors.affiliation: Jimma University, School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia. Electronic address: endalew.zemene@ju.edu.et.
authors.forename: Endalew
authors.initials: E
authors.lastname: Zemene
authors.affiliation: Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, of Health Sciences, Jimma University, Jimma, Ethiopia. Electronic address: sultan.suleman@ju.edu.et.
authors.forename: Sultan
authors.initials: S
authors.lastname: Suleman
authors.affiliation: Jimma University, School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia. Electronic address: abdissa.hordofa@ju.edu.et.
authors.forename: Abdissa
authors.initials: A
authors.lastname: Biruksew
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use*; D002738:Chloroquine / Q000627:therapeutic use*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006400:Hematocrit; D006801:Humans; D007223:Infant; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D018512:Parasitemia / Q000469:parasitology; D012008:Recurrence; D016019:Survival Analysis
chemical_list: D000962:Antimalarials; D002738:Chloroquine
keywords: CRPv; Chloroquine; Efficacy; Ethiopia; Plasmodium vivax; Shawa Robit; Treatment failure