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Plasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar.

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dc.contributor Artsen Zonder Grenzen, Médecins Sans Frontières-Holland, Yangon, Myanmar, Thailand.
dc.creator Smithuis, F
dc.creator Monti, F
dc.creator Grundl, M
dc.creator Oo, A Z
dc.creator Kyaw, T T
dc.creator Phe, O
dc.creator White, N J
dc.date 2008-02-07T16:58:23Z
dc.date.accessioned 2017-01-31T07:09:39Z
dc.date.available 2017-01-31T07:09:39Z
dc.identifier Plasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar., 91 (4):468-72 Trans. R. Soc. Trop. Med. Hyg.
dc.identifier 0035-9203
dc.identifier 9373658
dc.identifier http://hdl.handle.net/10144/17730
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/17730
dc.identifier Transactions of the Royal Society of Tropical Medicine and Hygiene
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/17730
dc.description In Rakhine State, on the western border of Myanmar, the efficacy of chloroquine (CQ) and pyrimethamine/ sulfadoxine (PS), the current treatments for uncomplicated Plasmodium falciparum malaria in this area, was evaluated in an open comparative study of 289 patients, stratified prospectively into 3 age groups. Chloroquine treatment was associated with more rapid clinical recovery (P = 0.03), but the overall cure rates were worse than for PS treatment; failure to clear parasitaemia or recrudescence within 14 d occurred in 72% (102/141) of cases treated with CQ compared to 47% (69/148) of those who received PS (P < 0.0001, adjusted for age). Failure rates at day 28 increased to 82% (116/141) in the CQ group and 67% (99/148) in the PS group (P = 0.003). The risk of treatment failure was significantly higher in children under 15 years old than in adults for both CQ (relative risk [RR] = 2.6; 95% confidence interval [95% CI] 1.3-5.2) and PS (RR = 2.2; 95% CI 1.4-3.3). Mefloquine (15 mg base/kg) proved to be highly effective as a treatment for CQ and PS resistant P. falciparum; only 2 of 75 patients (3%) had early treatment failures (< or = day 7), and the overall failure rate by day 42 was 7%. There is a very high level of chloroquine and PS resistance in P.falciparum on the western border of Myanmar, but mefloquine was effective in the area.
dc.language en
dc.publisher Elsevier
dc.relation http://www.sciencedirect.com/science/journal/00359203
dc.rights Archived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.asp
dc.title Plasmodium falciparum: sensitivity in vivo to chloroquine, pyrimethamine/sulfadoxine and mefloquine in western Myanmar.


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