Chloroquine resistant Plasmodium falciparum malaria in Osogbo Nigeria: efficacy of amodiaquine + sulfadoxine-pyrimethamine and chloroquine + chlorpheniramine for treatment
Mem. Inst. Oswaldo Cruz
; 103(1): 79-84, Feb. 2008. ilus, tab
Article
in English
| LILACS
| ID: lil-478883
Responsible library:
BR1.1
ABSTRACT
Chloroquine (CQ) resistance in Plasmodium falciparum contributes to increasing malaria-attributable morbidity and mortality in Sub-Saharan Africa. Despite a change in drug policy, continued prescription of CQ did not abate. Therefore the therapeutic efficacy of CQ in uncomplicated falciparum malaria patients was assessed in a standard 28-day protocol in 116 children aged between six and 120 months in Osogbo, Southwest Nigeria. Parasitological and clinical assessments of response to treatment showed that 72 (62.1 percent) of the patients were cured and 44 (37.9 percent) failed the CQ treatment. High initial parasite density and young age were independent predictors for early treatment failure. Out of the 44 patients that failed CQ, 24 received amodiaquine + sulphadoxine/pyrimethamine (AQ+SP) and 20 received chlorpheniramine + chloroquine (CH+CQ) combinations. Mean fever clearance time in those treated with AQ+SP was not significantly different from those treated with CH+CQ (p = 0.05). There was no significant difference in the mean parasite density of the two groups. The cure rate for AQ+SP group was 92 percent while those of CH+CQ was 85 percent. There was a significant difference in parasite clearance time (p = 0.01) between the two groups. The 38 percent treatment failure for CQ reported in this study is higher than the 10 percent recommended by World Health Organization in other to effect change in antimalarial treatment policy. Hence we conclude that CQ can no more be solely relied upon for the treatment of falciparum malaria in Osogbo, Nigeria. AQ+SP and CH+CQ are effective in the treatment of acute uncomplicated malaria and may be considered as useful alternative drugs in the absence of artemisinin-based combination therapies.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
/
Neglected Diseases
Health problem:
Target 3.8 Achieve universal access to health
/
Malaria
/
Neglected Diseases
Database:
LILACS
Main subject:
Plasmodium falciparum
/
Malaria, Falciparum
/
Histamine H1 Antagonists
/
Antimalarials
Type of study:
Practice guideline
/
Prognostic study
Limits:
Animals
/
Female
/
Humans
/
Male
Country/Region as subject:
Africa
Language:
English
Journal:
Mem. Inst. Oswaldo Cruz
Journal subject:
Tropical Medicine
/
Parasitology
Year:
2008
Document type:
Article
Affiliation country:
Nigeria
Institution/Affiliation country:
College of Health Sciences/NG
/
Ladoke Akintola University Teaching Hospital/NG