Añez Arletta, Navarro-Costa Dennis, Yucra Omar, Garnica Cecilia, Melgar Viviana, Moscoso Manuel, Arteaga Ricardo, Nakao Gladys
Organización Mundial de la Salud, Organización Panamericana de la Salud, La Paz, Bolivia.
Biomedica. 2012 Oct-Dec;32(4):527-35. doi: 10.1590/S0120-41572012000400008.
Knowledge of the therapeutic efficacy of chloroquine for Plasmodium vivax infections improves the capacity for surveillance of anti-malarial drug resistance.
The therapeutic efficacy of chloroquine as treatment was evaluated for uncomplicated Plasmodium vivax malaria in Bolivia.
An in vivo efficacy study of chloroquine was undertaken in three regions of Bolivia--Riberalta, Guayaramerín and Yacuiba. Two hundred and twenty-three patients (84, 80, and 59 in the three regions, respectively) aged over 5 years old were administered with chloroquine (25 mg/kg/three days) and followed for 28 days. Blood levels of chloroquine and desethylchloroquine were measured on day 2 and on the day of reappearance of parasitemia. The cumulative incidence of treatment failure was calculated using the Kaplan and Meier survival analysis.
The mean parasitemias (asexual) on day 0 were 6,147 parasites/μl of blood in the Riberalta population, 4,251 in Guayaramerín and 5,214 in Yacuiba. The average blood concentrations of chloroquine-desethylchloroquine during day 2 were 783, 817, and 815 ng/ml, respectively. No treatment failures were observed in Yacuiba, whereas in Riberalta and Guayaramerín, the frequencies of treatment failures were 6.2% and 10%. Blood levels of chloroquine and desethylchloroquine in patients with treatment failure showed values below 70 ng/ml on the day of reappearance of parasitemia.
Resistance of Plasmodium vivax to chloroquine was not demonstrated in three regions of Bolivia.
了解氯喹对间日疟原虫感染的治疗效果有助于提高对抗疟药物耐药性的监测能力。
评估氯喹在玻利维亚治疗非复杂性间日疟原虫疟疾的疗效。
在玻利维亚的三个地区——里韦拉尔塔、瓜亚拉梅林和亚基瓦进行了氯喹的体内疗效研究。对223名5岁以上患者（三个地区分别为84例、80例和59例）给予氯喹（25mg/kg/三天）并随访28天。在第2天和再次出现寄生虫血症当天测量氯喹和去乙基氯喹的血药浓度。使用Kaplan-Meier生存分析计算治疗失败的累积发生率。
第0天，里韦拉尔塔人群的平均无性体寄生虫血症为每微升血液6147个寄生虫，瓜亚拉梅林为4251个，亚基瓦为5214个。第2天氯喹-去乙基氯喹的平均血药浓度分别为783、817和815ng/ml。在亚基瓦未观察到治疗失败，而在里韦拉尔塔和瓜亚拉梅林，治疗失败的频率分别为6.2%和10%。治疗失败患者的氯喹和去乙基氯喹血药浓度在再次出现寄生虫血症当天显示低于70ng/ml。
在玻利维亚的三个地区未证实间日疟原虫对氯喹耐药。
