Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia.
Malaria and Other Parasitic Diseases Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Malar J. 2024 Jun 10;23(1):183. doi: 10.1186/s12936-024-05009-7.
Plasmodium vivax malaria is a leading cause of morbidity in Ethiopia. The first-line treatment for P. vivax is chloroquine (CQ) and primaquine (PQ), but there have been local reports of CQ resistance. A clinical study was conducted to determine the efficacy of CQ for the treatment of P. vivax malaria in southern Ethiopia.
In 2021, patients with P. vivax mono-infection and uncomplicated malaria were enrolled and treated with 25 mg/kg CQ for 3 consecutive days. Patients were followed for 28 days according to WHO guidelines. The data were analysed using per-protocol (PP) and Kaplan‒Meier (K‒M) analyses to estimate the risk of recurrent P. vivax parasitaemia on day 28.
A total of 88 patients were enrolled, 78 (88.6%) of whom completed the 28 days of follow-up. Overall, 76 (97.4%) patients had adequate clinical and parasitological responses, and two patients had late parasitological failures. The initial therapeutic response was rapid, with 100% clearance of asexual parasitaemia within 48 h.
Despite previous reports of declining chloroquine efficacy against P. vivax, CQ retains high therapeutic efficacy in southern Ethiopia, supporting the current national treatment guidelines. Ongoing clinical monitoring of CQ efficacy supported by advanced molecular methods is warranted to inform national surveillance and ensure optimal treatment guidelines.
间日疟原虫疟疾是埃塞俄比亚发病率的主要原因。间日疟原虫的一线治疗药物是氯喹（CQ）和伯氨喹（PQ），但有当地报道称 CQ 出现了耐药性。进行了一项临床研究，以确定 CQ 治疗南部埃塞俄比亚间日疟原虫疟疾的疗效。
2021 年，招募了患有单纯性间日疟原虫感染和无并发症疟疾的患者，并使用 25mg/kg 的 CQ 连续治疗 3 天。根据世界卫生组织的指南，对患者进行了 28 天的随访。使用符合方案（PP）和 Kaplan-Meier（K-M）分析来评估第 28 天复发性间日疟原虫血症的风险。
共招募了 88 名患者，其中 78 名（88.6%）完成了 28 天的随访。总体而言，76 名（97.4%）患者具有充分的临床和寄生虫学反应，有两名患者出现了迟发性寄生虫学失败。初始治疗反应迅速，在 48 小时内 100%清除无性体寄生虫血症。
尽管之前有报道称 CQ 对间日疟原虫的疗效下降，但 CQ 在埃塞俄比亚南部仍具有很高的治疗效果，支持当前的国家治疗指南。需要持续进行临床监测 CQ 的疗效，并结合先进的分子方法，为国家监测提供信息，并确保最佳的治疗指南。
