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Efficacy of chloroquine for the treatment of Plasmodium vivax in the Saharan zone in Mauritania.

Ould Ahmedou Salem MS, Mohamed Lemine YO, Deida JM, Lemrabott MA, Ouldabdallahi M, Ba MD, Boukhary AO, Khairy ML, Abdel Aziz MB, Ringwald P, Basco LK, Niang SD, Lebatt SM - Malar. J. (2015)

Bottom Line: Treatment was well-tolerated.One patient was excluded on day 1 due to urticaria and treated with artesunate-amodiaquine.Further epidemiological studies are required to map the distribution of P. vivax and P. falciparum in the country.

View Article: PubMed Central - PubMed

Affiliation: Unité de Recherche « Génome et Milieux », Faculté des Sciences et Techniques, Université des Sciences, de Technologie et de Médecine, Nouveau Campus Universitaire, Nouakchott, BP 5026, Mauritania. salem0606@yahoo.fr.

ABSTRACT

Background: In 2006, the Mauritanian Ministry of Health adopted a new therapeutic strategy based on the systematic use of artemisinin-based combination therapy (ACT), artesunate-amodiaquine and artemether-lumefantrine, for the first- and second-line treatment of uncomplicated malaria, respectively, regardless of Plasmodium spp. In the Saharan zone of the country, recent studies have shown that Plasmodium vivax largely predominates over Plasmodium falciparum. Anti-malarial drug response of P. vivax has not been evaluated in Mauritania. The aim of the present study was to evaluate the clinical efficacy and tolerance of chloroquine to treat P. vivax malaria in Mauritanian patients.

Methods: Plasmodium vivax-infected patients aged > 6 months old were enrolled in Nouakchott and Atar in September-October 2013. Chloroquine was administered at the standard dose of 25 mg base/kg body weight over three days. Patients were followed until day 28, according to the standard 2009 World Health Organization protocol.

Results: A total of 128 patients (67 in Nouakchott and 61 in Atar) were enrolled in the study. Seven patients (5.5%) were either excluded or lost to follow-up. Based on the per protocol analysis, chloroquine efficacy (adequate clinical and parasitological response) was 100%. Treatment was well-tolerated. One patient was excluded on day 1 due to urticaria and treated with artesunate-amodiaquine.

Conclusions: Although the current national treatment guideline recommends artesunate-amodiaquine for the first-line treatment of uncomplicated malaria, including P. vivax malaria, chloroquine may still have an important role to play in anti-malarial chemotherapy in Mauritania. Further epidemiological studies are required to map the distribution of P. vivax and P. falciparum in the country.

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Related in: MedlinePlus

Study sites in Mauritania.
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Fig1: Study sites in Mauritania.

Mentions: The clinical studies were conducted simultaneously in two study sites in central and northern Mauritania: Nouakchott (18°05′02″ north, 15°58′42″ west), the capital city of Mauritania, and Atar (20°31′06″ north, 13°03′13″ west, the regional capital of the Adrar) (Figure 1). In 2013, it was estimated that the population in Nouakchott was 899,887 inhabitants [Office National de la Statistique, Nouakchott, Mauritania]. Based on previous studies, that showed a high prevalence of laboratory-confirmed P. vivax malaria in the northern districts of Nouakchott [2,3], Teyarett health centre was selected for the present study. In 2012, the health centre recorded more than 1,000 P. vivax malaria, confirmed by rapid diagnostic test for malaria.Figure 1


Efficacy of chloroquine for the treatment of Plasmodium vivax in the Saharan zone in Mauritania.

Ould Ahmedou Salem MS, Mohamed Lemine YO, Deida JM, Lemrabott MA, Ouldabdallahi M, Ba MD, Boukhary AO, Khairy ML, Abdel Aziz MB, Ringwald P, Basco LK, Niang SD, Lebatt SM - Malar. J. (2015)

Study sites in Mauritania.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4318167&req=5

Fig1: Study sites in Mauritania.
Mentions: The clinical studies were conducted simultaneously in two study sites in central and northern Mauritania: Nouakchott (18°05′02″ north, 15°58′42″ west), the capital city of Mauritania, and Atar (20°31′06″ north, 13°03′13″ west, the regional capital of the Adrar) (Figure 1). In 2013, it was estimated that the population in Nouakchott was 899,887 inhabitants [Office National de la Statistique, Nouakchott, Mauritania]. Based on previous studies, that showed a high prevalence of laboratory-confirmed P. vivax malaria in the northern districts of Nouakchott [2,3], Teyarett health centre was selected for the present study. In 2012, the health centre recorded more than 1,000 P. vivax malaria, confirmed by rapid diagnostic test for malaria.Figure 1

Bottom Line: Treatment was well-tolerated.One patient was excluded on day 1 due to urticaria and treated with artesunate-amodiaquine.Further epidemiological studies are required to map the distribution of P. vivax and P. falciparum in the country.

View Article: PubMed Central - PubMed

Affiliation: Unité de Recherche « Génome et Milieux », Faculté des Sciences et Techniques, Université des Sciences, de Technologie et de Médecine, Nouveau Campus Universitaire, Nouakchott, BP 5026, Mauritania. salem0606@yahoo.fr.

ABSTRACT

Background: In 2006, the Mauritanian Ministry of Health adopted a new therapeutic strategy based on the systematic use of artemisinin-based combination therapy (ACT), artesunate-amodiaquine and artemether-lumefantrine, for the first- and second-line treatment of uncomplicated malaria, respectively, regardless of Plasmodium spp. In the Saharan zone of the country, recent studies have shown that Plasmodium vivax largely predominates over Plasmodium falciparum. Anti-malarial drug response of P. vivax has not been evaluated in Mauritania. The aim of the present study was to evaluate the clinical efficacy and tolerance of chloroquine to treat P. vivax malaria in Mauritanian patients.

Methods: Plasmodium vivax-infected patients aged > 6 months old were enrolled in Nouakchott and Atar in September-October 2013. Chloroquine was administered at the standard dose of 25 mg base/kg body weight over three days. Patients were followed until day 28, according to the standard 2009 World Health Organization protocol.

Results: A total of 128 patients (67 in Nouakchott and 61 in Atar) were enrolled in the study. Seven patients (5.5%) were either excluded or lost to follow-up. Based on the per protocol analysis, chloroquine efficacy (adequate clinical and parasitological response) was 100%. Treatment was well-tolerated. One patient was excluded on day 1 due to urticaria and treated with artesunate-amodiaquine.

Conclusions: Although the current national treatment guideline recommends artesunate-amodiaquine for the first-line treatment of uncomplicated malaria, including P. vivax malaria, chloroquine may still have an important role to play in anti-malarial chemotherapy in Mauritania. Further epidemiological studies are required to map the distribution of P. vivax and P. falciparum in the country.

Show MeSH
Related in: MedlinePlus