In-vivo efficacy of chloroquine to clear asymptomatic infections in mozambican adults: a randomized, placebo-controlled Trial with Implications for Elimination Strategies
Sci. rep. (Nat. Publ. Group)
; 7(1356): 1-10, maio 2, 2017. tab, graf
Article
in English
| RSDM
| ID: biblio-1527329
Responsible library:
MZ1.1
ABSTRACT
Recent reports regarding the re-emergence of parasite sensitivity to chloroquine call for a new consideration of this drug as an interesting complementary tool in malaria elimination efforts, given its good safety profile and long half-life. A randomized (21), single-blind, placebo-controlled trial was conducted in Manhiça, Mozambique, to assess the in-vivo efficacy of chloroquine to clear plasmodium falciparum (Pf) asymptomatic infections. Primary study endpoint was the rate of adequate and parasitological response (ACPR) to therapy on day 28 (PCR-corrected). Day 0 isolates were analyzed to assess the presence of the PfCRT-76T CQ resistance marker. A total of 52 and 27 male adults were included in the CQ and Placebo group respectively. PCR-corrected ACPR was significantly higher in the CQ arm 89.4% (95%CI 80-98%) compared to the placebo (p < 0.001). CQ cleared 49/50 infections within the first 72 h while placebo cleared 12/26 (LRT p < 0.001). The PfCRT-76T mutation was present only in one out of 108 (0.9%) samples at baseline, well below the 84% prevalence found in 1999 in the same area. This study presents preliminary evidence of a return of chloroquine sensitivity in Mozambican Pf isolates, and calls for its further evaluation in community-based malaria elimination efforts, in combination with other effective anti-malarials.
Full text:
Available
Collection:
National databases
/
MZ
Database:
RSDM
Main subject:
Plasmodium falciparum
/
Drug Resistance
Limits:
Adult
/
Humans
/
Male
Country/Region as subject:
Africa
Language:
English
Journal:
Sci. rep. (Nat. Publ. Group)
Year:
2017
Document type:
Article
Institution/Affiliation country:
Centro de investigação em saúde de manhiça (CISM)/ES
/
Centro de investigação em saúde de manhiça (CISM)/MZ
/
ISGlobal, Barcelona ctr. int. health res. (CRESIB), Hospital clínic - Universitat de barcelona/ES
/
National malaria control programme (NMCP), Ministry of health/MZ