In vivo efficacy of chloroquine plus primaquine combination therapy against uncomplicated Plasmodium vivax malaria in Limu Kossa District, Jimma Zone, Southwest Ethiopia.

IF 2.4 3区 医学 Q3 INFECTIOUS DISEASES
Wakgari Asfaw, Temesgen Bekele, Geleta Geshere, Eba Alemayehu Simma, Chernet Tuge Deressa, Tsige Ketema
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引用次数: 0

Abstract

Background: Plasmodium vivax is the second most common malaria parasite in Ethiopia. It has been treated with chloroquine (CQ) for the past seven decades. However, the emergence of CQ-resistant strains in the nation urged the Federal Ministry of Health of Ethiopia to review its national malaria treatment guideline in 2018. In the revised guideline, the first-line treatment for uncomplicated P. vivax infection is a combination of CQ and primaquine (PQ). Thus, the present study was designed to evaluate the in vivo efficacy of CQ and PQ combination therapy against clinical P. vivax mono-infection in one of the malaria-endemic areas of Ethiopia.

Methods: An open-label prospective clinical trial was conducted in the Limmu Kossa District, Jimma zone, Southwest Ethiopia, from September 2023 to March 2024. A total of 108 patients were recruited for the study. All participants received treatment with CQ at a dosage of 25 mg/kg over three days, followed by PQ at 0.25 mg/kg for 14 consecutive days. Patients were monitored for 42 days for any signs of treatment failure and malaria clinical symptoms, as per the World Health Organization (WHO) guidelines for anti-malarial drug evaluation. Additionally, haemoglobin (Hb) levels, body temperature, any adverse events, and signs of haemolysis were assessed. Data was analysed using R-software (version 4.0.0) and a significant level was considered at p < 0.05.

Results: The median age of the patients was 23 years, ranging from 2.5 to 62 years. Of the 108 patients initially recruited, 100 completed the 42-day follow-up period. The combination therapy of CQ and PQ for uncomplicated clinical P. vivax malaria demonstrated excellent therapeutic efficacy, with a 100% cure rate observed at both day 28 and day 42. Additionally, the recommended low dose of PQ (0.25 mg/kg) was well-tolerated, with no signs of. Additionally, most common malaria symptoms were disappeared early in the follow-up period.

Conclusion: The combination of CQ plus PQ has exhibited excellent efficacy against uncomplicated P. vivax malaria mono-infections. To preserve this efficacy, it is critical to ensure patients adhere to the full course of PQ treatment, despite its extended duration. Therefore, health authorities should put emphasis on the boosting of the public on the importance of finishing the prescribed medication regimen.

氯喹加伯氨喹联合疗法对埃塞俄比亚西南部吉马区利穆科萨县无并发症间日疟原虫疟疾的体内疗效。
背景:间日疟原虫是埃塞俄比亚第二常见的疟疾寄生虫。过去七十年来,一直使用氯喹(CQ)治疗。然而,国内出现的耐 CQ 菌株促使埃塞俄比亚联邦卫生部于 2018 年重新审查其国家疟疾治疗指南。在修订后的指南中,无并发症间日疟原虫感染的一线治疗是 CQ 和伯氨喹(PQ)的组合。因此,本研究旨在评估 CQ 和 PQ 联合疗法对埃塞俄比亚疟疾流行地区之一的临床单例间日疟原虫感染的体内疗效:方法:2023 年 9 月至 2024 年 3 月在埃塞俄比亚西南部吉马地区的 Limmu Kossa 区进行了一项开放标签前瞻性临床试验。研究共招募了 108 名患者。所有参与者均接受了为期三天、剂量为 25 毫克/千克的 CQ 治疗,随后连续 14 天接受剂量为 0.25 毫克/千克的 PQ 治疗。根据世界卫生组织(WHO)的抗疟药物评估指南,对患者进行了为期 42 天的监测,以观察治疗失败迹象和疟疾临床症状。此外,还对血红蛋白(Hb)水平、体温、任何不良反应和溶血迹象进行了评估。数据使用 R 软件(4.0.0 版)进行分析,以 p 为显著水平:患者年龄中位数为 23 岁,从 2.5 岁到 62 岁不等。在最初招募的 108 名患者中,100 人完成了 42 天的随访。CQ 和 PQ 联合疗法治疗无并发症的间日疟临床病例显示出卓越的疗效,第 28 天和第 42 天的治愈率均为 100%。此外,推荐的低剂量 PQ(0.25 毫克/千克)耐受性良好,没有任何症状。此外,大多数常见疟疾症状在随访初期就已消失:结论:CQ 加 PQ 的组合疗法对无并发症的间日疟原虫单一感染有很好的疗效。要保持这种疗效,关键是要确保患者坚持整个疗程的 PQ 治疗,尽管疗程较长。因此,卫生部门应重视向公众宣传完成处方药物治疗的重要性。
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来源期刊
Malaria Journal
Malaria Journal 医学-寄生虫学
CiteScore
5.10
自引率
23.30%
发文量
334
审稿时长
2-4 weeks
期刊介绍: Malaria Journal is aimed at the scientific community interested in malaria in its broadest sense. It is the only journal that publishes exclusively articles on malaria and, as such, it aims to bring together knowledge from the different specialities involved in this very broad discipline, from the bench to the bedside and to the field.
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