Soto J, Toledo J, Gutierrez P, Luzz M, Llinas N, Cedeño N, Dunne M, Berman J
Consorcio de Investigaciones Bioclínicas, Bogotá, Colombia.
Am J Trop Med Hyg. 2001 Aug;65(2):90-3. doi: 10.4269/ajtmh.2001.65.90.
Chloroquine-resistant Plasmodium vivax has been the subject of numerous case reports and prospective studies from Oceania and Asia. In contrast, only case reports exist from the Americas. We performed a prospective study with 28-day follow-up of clinical responses to chloroquine in 2 P. vivax-endemic regions of Colombia. Three (11%) of 27 patients failed to respond to treatment with the standard regimen of chloroquine (1,500 mg of base over 3 days). One patient demonstrated RI resistance on Day 26; one patient demonstrated RI resistance due to recrudescence of blood stages on Day 11; and one patient demonstrated RII resistance of blood stages by never displaying clearing of peripheral parasitemia. All patients were successfully treated with primaquine, which has some blood stage efficacy against P. vivax, combined with a second course of chloroquine. Clinical resistance of P. vivax to chloroquine is present in Colombia and should be monitored in the Americas.
耐氯喹间日疟原虫一直是大洋洲和亚洲众多病例报告及前瞻性研究的主题。相比之下，美洲仅有病例报告。我们在哥伦比亚两个间日疟原虫流行地区对氯喹的临床反应进行了为期28天的前瞻性研究。27例患者中有3例（11%）对氯喹标准疗法（3天内服用1500毫克碱基）治疗无反应。1例患者在第26天表现出RI耐药；1例患者在第11天因血期复发表现出RI耐药；1例患者因外周血寄生虫血症从未清除而表现出血期RII耐药。所有患者均通过伯氨喹（对间日疟原虫有一定血期疗效）联合第二疗程氯喹成功治愈。哥伦比亚存在间日疟原虫对氯喹的临床耐药情况，美洲应予以监测。
