Henry M C, Eggelte T A, Watson P, Docters van Leeuwen B, Bakker D A, Kluin J
Centre Néerlandais (Wageningen Agricultural University), Côte d'Ivoire.
Trop Med Int Health. 1996 Oct;1(5):610-5. doi: 10.1111/j.1365-3156.1996.tb00086.x.
The parasitological, clinical and haematological responses to chloroquine treatment were studied in children during a 28-day follow-up in an area of Côte d'Ivoire with intermediate chloroquine resistance. The parasitological, clinical and haematological responses to Fansidar were also investigated in patients who returned to the health centre within 28 days with symptoms of malaria. Of 82 children aged 0-9 years who completed the study, only 67% were parasite-negative on thick blood film on day 7, which decreased to 21% by day 28. While chloroquine treatment still produced clinical remission at day 7 in 95% of the children, 35% had recurrent fever with concomitant parasitaemia before day 28. All fever cases subsequently treated with Fansidar remained parasite-negative over a period of 28 days. On day 28 the haematocrit levels were higher in those children who responded successfully to treatment with either chloroquine or Fansidar than in the children who were still parasite-positive but without fever (two-tailed t-test, P = 0.02). The rate of resistance to chloroquine was most pronounced among the younger children (< 5 years), 18% of whom showed clinical failure by day 14. This study underlines the importance of monitoring the durability of response to chloroquine treatment for at least 14 days in young children in Côte d'Ivoire.
在科特迪瓦一个存在中等程度氯喹耐药性的地区，对儿童进行了为期28天的随访，研究氯喹治疗的寄生虫学、临床和血液学反应。还对在28天内带着疟疾症状返回健康中心的患者进行了甲氟喹治疗的寄生虫学、临床和血液学反应研究。在82名完成研究的0至9岁儿童中，只有67%在第7天厚血膜检查时寄生虫呈阴性，到第28天时这一比例降至21%。虽然氯喹治疗在第7天时仍使95%的儿童临床症状缓解，但35%的儿童在第28天前出现发热复发并伴有寄生虫血症。随后所有用甲氟喹治疗的发热病例在28天内均保持寄生虫阴性。在第28天，成功用氯喹或甲氟喹治疗的儿童的血细胞比容水平高于仍寄生虫呈阳性但无发热的儿童（双侧t检验，P = 0.02）。氯喹耐药率在年龄较小的儿童（<5岁）中最为明显，其中18%在第14天时出现临床治疗失败。这项研究强调了在科特迪瓦对幼儿氯喹治疗反应的持续性至少监测14天的重要性。
