Therapeutic assessment of chloroquine-primaquine combined regimen in adult cohort of Plasmodium vivax malaria from a tertiary care hospital in southwestern India

Kumar Rishikesh, Asha Kamath, Manjunatha H. Hande, Sudha Vidyasagar, Raviraja V. Acharya, Vasudeva Acharya, Jayaprakash Belle, Ananthakrishna B. Shastry, Kavitha Saravu

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Abstract

Background: Of late there have been accounts of therapeutic failure and chloroquine resistance in Plasmodium vivax malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine-primaquine (CQ-PQ) combined regimen in a cohort of uncomplicated P. vivax mono-infection. Methods: A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection P. vivax malaria as per the World Health Organization's protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks. Results: Of a total of 125 participants recruited, 122 (97.6%) completed day 28 follow up, three (2.4%) participants were lost to follow-up. Eight patients (6.4%) were ascertained to have mixed P. vivax and Plasmodium falciparum infection by nested polymerase chain reaction test. The majority of subjects (56.8%, 71/125) became aparasitaemic on day 2 followed by 35.2% (44/125) on day 3, and 8% (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8%, 1/125) occurred on day 3 due to persistence of fever and parasitaemia. Conclusions: CQ-PQ combined regimen remains outstandingly effective for uncomplicated P. vivax malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.

Original languageEnglish
Article number310
JournalMalaria Journal
Volume14
Issue number1
DOIs
Publication statusPublished - 11-08-2015

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Primaquine
Vivax Malaria
Chloroquine
Tertiary Healthcare
Tertiary Care Centers
India
Plasmodium vivax
Body Weight
Therapeutics
Parasitemia
Lost to Follow-Up
Antimalarials
Plasmodium falciparum
Infection
Treatment Failure
Malaria
Fever
Prospective Studies
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Infectious Diseases

Cite this

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title = "Therapeutic assessment of chloroquine-primaquine combined regimen in adult cohort of Plasmodium vivax malaria from a tertiary care hospital in southwestern India",
abstract = "Background: Of late there have been accounts of therapeutic failure and chloroquine resistance in Plasmodium vivax malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine-primaquine (CQ-PQ) combined regimen in a cohort of uncomplicated P. vivax mono-infection. Methods: A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection P. vivax malaria as per the World Health Organization's protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks. Results: Of a total of 125 participants recruited, 122 (97.6{\%}) completed day 28 follow up, three (2.4{\%}) participants were lost to follow-up. Eight patients (6.4{\%}) were ascertained to have mixed P. vivax and Plasmodium falciparum infection by nested polymerase chain reaction test. The majority of subjects (56.8{\%}, 71/125) became aparasitaemic on day 2 followed by 35.2{\%} (44/125) on day 3, and 8{\%} (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8{\%}, 1/125) occurred on day 3 due to persistence of fever and parasitaemia. Conclusions: CQ-PQ combined regimen remains outstandingly effective for uncomplicated P. vivax malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.",
author = "Kumar Rishikesh and Asha Kamath and Hande, {Manjunatha H.} and Sudha Vidyasagar and Acharya, {Raviraja V.} and Vasudeva Acharya and Jayaprakash Belle and Shastry, {Ananthakrishna B.} and Kavitha Saravu",
year = "2015",
month = "8",
day = "11",
doi = "10.1186/s12936-015-0824-y",
language = "English",
volume = "14",
journal = "Malaria Journal",
issn = "1475-2875",
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number = "1",

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TY - JOUR

T1 - Therapeutic assessment of chloroquine-primaquine combined regimen in adult cohort of Plasmodium vivax malaria from a tertiary care hospital in southwestern India

AU - Rishikesh, Kumar

AU - Kamath, Asha

AU - Hande, Manjunatha H.

AU - Vidyasagar, Sudha

AU - Acharya, Raviraja V.

AU - Acharya, Vasudeva

AU - Belle, Jayaprakash

AU - Shastry, Ananthakrishna B.

AU - Saravu, Kavitha

PY - 2015/8/11

Y1 - 2015/8/11

N2 - Background: Of late there have been accounts of therapeutic failure and chloroquine resistance in Plasmodium vivax malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine-primaquine (CQ-PQ) combined regimen in a cohort of uncomplicated P. vivax mono-infection. Methods: A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection P. vivax malaria as per the World Health Organization's protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks. Results: Of a total of 125 participants recruited, 122 (97.6%) completed day 28 follow up, three (2.4%) participants were lost to follow-up. Eight patients (6.4%) were ascertained to have mixed P. vivax and Plasmodium falciparum infection by nested polymerase chain reaction test. The majority of subjects (56.8%, 71/125) became aparasitaemic on day 2 followed by 35.2% (44/125) on day 3, and 8% (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8%, 1/125) occurred on day 3 due to persistence of fever and parasitaemia. Conclusions: CQ-PQ combined regimen remains outstandingly effective for uncomplicated P. vivax malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.

AB - Background: Of late there have been accounts of therapeutic failure and chloroquine resistance in Plasmodium vivax malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine-primaquine (CQ-PQ) combined regimen in a cohort of uncomplicated P. vivax mono-infection. Methods: A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection P. vivax malaria as per the World Health Organization's protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks. Results: Of a total of 125 participants recruited, 122 (97.6%) completed day 28 follow up, three (2.4%) participants were lost to follow-up. Eight patients (6.4%) were ascertained to have mixed P. vivax and Plasmodium falciparum infection by nested polymerase chain reaction test. The majority of subjects (56.8%, 71/125) became aparasitaemic on day 2 followed by 35.2% (44/125) on day 3, and 8% (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8%, 1/125) occurred on day 3 due to persistence of fever and parasitaemia. Conclusions: CQ-PQ combined regimen remains outstandingly effective for uncomplicated P. vivax malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.

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U2 - 10.1186/s12936-015-0824-y

DO - 10.1186/s12936-015-0824-y

M3 - Article

VL - 14

JO - Malaria Journal

JF - Malaria Journal

SN - 1475-2875

IS - 1

M1 - 310

ER -