Brandling-Bennett A D, Oloo A J, Watkins W M, Boriga D A, Kariuki D M, Collins W E
Clinical Research Centre, Kenya Medical Research Institute, Nairobi.
Trans R Soc Trop Med Hyg. 1988;82(6):833-7. doi: 10.1016/0035-9203(88)90009-0.
106 children aged 1-10 years who had pure Plasmodium falciparum infections and temperatures greater than or equal to 38 degrees C were treated with chloroquine base, 25 mg/kg body weight. 29% of the infections were sensitive in vivo, 41% recurred within 4 weeks (RI), 26% were RII resistant, and 4% were RII resistant. Rieckmann micro in vitro tests were successful in 64% of isolates obtained from these children; 63% were resistant to chloroquine. In 58 paired isolates obtained before and after treatment, the level of chloroquine sensitivity was lower in the parasites persisting or recurring after treatment. All children except 2 of the 4 with RIII resistance became afebrile an average of 1.4 d after starting treatment and their other symptoms resolved in an average of 1.8 d. By day 28, 57% of the children with RI resistance and 78% of those with RII resistance had recurrence of fever and other symptoms, compared with 19% of children with sensitive infections. No relationship was observed between the clinical or parasitological response and age, nutritional status, haematocrit, splenomegaly, presence of sickle-cell trait, or seropositivity to malaria by enzyme-linked immunosorbent assay. The study demonstrates that, in most children with malaria in an area of intermediate chloroquine resistance, fever and other symptoms resolve at least temporarily when treated with chloroquine.
106名年龄在1至10岁之间、单纯感染恶性疟原虫且体温高于或等于38摄氏度的儿童接受了25毫克/千克体重的氯喹碱治疗。29%的感染在体内敏感，41%在4周内复发（RI），26%为RII耐药，4%为RIII耐药。从这些儿童中获得的分离株有64%的Rieckmann微量体外试验成功；63%对氯喹耐药。在治疗前后获得的58对分离株中，治疗后持续存在或复发的寄生虫中氯喹敏感性水平较低。除4名RIII耐药儿童中的2名外，所有儿童在开始治疗后平均1.4天退热，其他症状平均1.8天消退。到第28天，RI耐药儿童中有57%、RII耐药儿童中有78%出现发热和其他症状复发，而敏感感染儿童中这一比例为19%。未观察到临床或寄生虫学反应与年龄、营养状况、血细胞比容、脾肿大、镰状细胞性状的存在或通过酶联免疫吸附测定法检测的疟疾血清阳性之间存在关联。该研究表明，在氯喹耐药性中等的地区，大多数患疟疾的儿童用氯喹治疗时，发热和其他症状至少会暂时消退。
