Limits...
Adherence to 7-day primaquine treatment for the radical cure of P. vivax in the Peruvian Amazon.

Grietens KP, Soto V, Erhart A, Ribera JM, Toomer E, Tenorio A, Montalvo TG, Rodriguez H, Cuentas AL, D'Alessandro U, Gamboa D - Am. J. Trop. Med. Hyg. (2010)

Bottom Line: Despite being free of charge, treatment adherence to 7-day primaquine for the radical cure of Plasmodium vivax was estimated at 62.2% among patients along the Iquitos-Nauta road in the Peruvian Amazon.Notably, patients were willing to adhere to the first 3 days of treatment during which symptoms are most apparent and include the characteristic chills.Nevertheless, as symptoms abate, the perceived aggravating characteristics of the medication outweigh the perceived advantages of treatment adherence.

View Article: PubMed Central - PubMed

Affiliation: Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium. kpeeters@itg.be

ABSTRACT
Despite being free of charge, treatment adherence to 7-day primaquine for the radical cure of Plasmodium vivax was estimated at 62.2% among patients along the Iquitos-Nauta road in the Peruvian Amazon. The principal reason for non-adherence was the perceived adverse effects related to local humoral illness conceptions that hold that malaria produces a hot state of body, which is further aggravated by the characteristically hot medical treatment. Notably, patients were willing to adhere to the first 3 days of treatment during which symptoms are most apparent and include the characteristic chills. Nevertheless, as symptoms abate, the perceived aggravating characteristics of the medication outweigh the perceived advantages of treatment adherence. Improving community awareness about the role of primaquine to prevent further malaria transmission and fostering a realistic system of direct observed treatment intake, organized at community level, can be expected to improve adherence to the radical cure of P. vivax in this area.

Show MeSH

Related in: MedlinePlus

Map of the study area. This figure appears in color at www.ajtmh.org.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2877405&req=5

Figure 1: Map of the study area. This figure appears in color at www.ajtmh.org.

Mentions: The study was conducted in the catchment area of the Paujil and Cahuide Health Centers (HC) in the district of San Juan situated along the road connecting Iquitos city to the small port city of Nauta (Figure 1), in the department of Loreto belonging to the Peruvian Amazon. Malaria distribution in Loreto is highly heterogeneous and contains foci of high incidence, such as the district of San Juan, which reported in 2007 the highest number of cases in the region (total of 4,075 for a population of 108,353).1 Malaria transmission is perennial with a peak during the rainy season between November and May. All age groups are at risk, although adults are more so than children, and most infections are symptomatic.6–8 The main vector is Anopheles darlingi, a highly anthropophilic species that recently (1990s) spread to this region because of new settlements and increasing forest exploitation.9,10


Adherence to 7-day primaquine treatment for the radical cure of P. vivax in the Peruvian Amazon.

Grietens KP, Soto V, Erhart A, Ribera JM, Toomer E, Tenorio A, Montalvo TG, Rodriguez H, Cuentas AL, D'Alessandro U, Gamboa D - Am. J. Trop. Med. Hyg. (2010)

Map of the study area. This figure appears in color at www.ajtmh.org.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2877405&req=5

Figure 1: Map of the study area. This figure appears in color at www.ajtmh.org.
Mentions: The study was conducted in the catchment area of the Paujil and Cahuide Health Centers (HC) in the district of San Juan situated along the road connecting Iquitos city to the small port city of Nauta (Figure 1), in the department of Loreto belonging to the Peruvian Amazon. Malaria distribution in Loreto is highly heterogeneous and contains foci of high incidence, such as the district of San Juan, which reported in 2007 the highest number of cases in the region (total of 4,075 for a population of 108,353).1 Malaria transmission is perennial with a peak during the rainy season between November and May. All age groups are at risk, although adults are more so than children, and most infections are symptomatic.6–8 The main vector is Anopheles darlingi, a highly anthropophilic species that recently (1990s) spread to this region because of new settlements and increasing forest exploitation.9,10

Bottom Line: Despite being free of charge, treatment adherence to 7-day primaquine for the radical cure of Plasmodium vivax was estimated at 62.2% among patients along the Iquitos-Nauta road in the Peruvian Amazon.Notably, patients were willing to adhere to the first 3 days of treatment during which symptoms are most apparent and include the characteristic chills.Nevertheless, as symptoms abate, the perceived aggravating characteristics of the medication outweigh the perceived advantages of treatment adherence.

View Article: PubMed Central - PubMed

Affiliation: Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium. kpeeters@itg.be

ABSTRACT
Despite being free of charge, treatment adherence to 7-day primaquine for the radical cure of Plasmodium vivax was estimated at 62.2% among patients along the Iquitos-Nauta road in the Peruvian Amazon. The principal reason for non-adherence was the perceived adverse effects related to local humoral illness conceptions that hold that malaria produces a hot state of body, which is further aggravated by the characteristically hot medical treatment. Notably, patients were willing to adhere to the first 3 days of treatment during which symptoms are most apparent and include the characteristic chills. Nevertheless, as symptoms abate, the perceived aggravating characteristics of the medication outweigh the perceived advantages of treatment adherence. Improving community awareness about the role of primaquine to prevent further malaria transmission and fostering a realistic system of direct observed treatment intake, organized at community level, can be expected to improve adherence to the radical cure of P. vivax in this area.

Show MeSH
Related in: MedlinePlus