Therapeutic efficacy of chloroquine for treatment of Plasmodium vivax malaria cases in Guragae zone southern Central Ethiopia

Abstract

Background Malaria continues to be a public health problem and important cause of morbidity and mortality in Ethiopia. Due to continuous interventions to combat malaria in endemic regions, a decline in malaria related deaths and morbidity has been registered. These gains, however, are threatened with the emergency of antimalarial drugs resistant strains of plasmodium parasites. This study aimed to determine therapeutic efficacy of chloroquine for treatment of Plasmodium vivax malaria cases in Guragae zone, southern central Ethiopia. Methods A one arm prospective study with recurrence of parasitaemia and clinical conditions of patients were evaluated on days 0, 1, 2, 3, 7, 14, and 28. Patients with Plasmodium vivax malaria mono infection and eligible for study inclusion criteria were recruited. SPSS-21 used for data analysis and management. Kaplan-Meier survival probability analysis was estimated. Mean geometric parasitaemia and average haemoglobin concentration were calculated. Results Among 87 total recruited subjects, 81 of them completed the 28 days follow up. More than half of (57.5%) the study participants had a history of fever and 42.5% of them had fever at the time of enrollment. The mean body temperature on day of recruitment was 38.2 °C and 36.8 °C on day 28. Geometric mean parasitaemia calculated on day of enrollment was 2270 parasites/μl of blood. Recurrence of parasitaemia was registered from two subjects during entire follow up. The mean haemoglobin concentration of study participants on day of enrolment was 11.8 g/ dl and 13.8 g/dl on day 28. Conclusion This study registered a high chloroquine efficacy rate among the study participants. Therefore, chloroquine remains efficacious for the treatment of Plasmodium vivax malaria in the study area. However, there is a need to monitor chloroquine resistance by employing molecular tools for better evaluation of treatment outcome.

Trend of malaria prevalence in Wolkite health center: an implication towards the elimination of malaria in Ethiopia by 2030

“…In addition, the performance difference of the laboratory personnel regarding malaria species identification might be attributed to increased prevalence. However, despite emerging chloroquine resistance P. vivax has been reported in southern Ethiopia [10], chloroquine is an efficacious drug for the treatment of P. vivax malaria in the study area [23].…”

“…In general, the prevalence of malaria in Wolkite health center showed a consistent downward trend from the year of 2015-2018. Plasmodium vivax seemed to be overlooked even though there were hardly any known drug resistance has been reported in the study area for P. vivax [23]. In addition, a recent randomized trial has reported the effectiveness and safety of short-course usage of Primaquine for a radical cure in P. vivax endemic areas of Ethiopia [34].…”

In vivo efficacy of anti-malarial drugs against clinical Plasmodium vivax malaria in Ethiopia: a systematic review and meta-analysis

“…Five studies reported data from a single study site (Bishoftu/Debrezeit) in different years and seasons [ 20 , 23 , 26 – 28 ]. Two other studies reported data from another single study site (Adama/Naziret) [ 26 , 27 ]. Figure 2 shows the distribution of the study sites from where the efficacy status of CQ has been reported (Fig.…”

“…Many studies from Ethiopia have reported a decreasing sensitivity of P. vivax to CQ [ 22 – 24 ], although this appears sporadic as some studies showed sustained efficacy of this drug [ 25 – 27 ]. Although not officially recommended in the Ethiopian malaria treatment guidelines, studies have investigated the efficacy of alternative treatments for vivax malaria, such as treatment with artemether-lumefantrine (AL); CQ combined with PQ; or, AL with PQ [ 25 , 28 – 30 ].…”

The analysis of evolution in eradicating mortalities caused by infectious diseases in East and Central African Countries coinciding with gross national income

“…The malaria incidence rate in 2015 was 91 per 1000 people at risk with an estimate of 214 million of new cases and 438000 mortalities [7]. The co-infection of HIV and Malaria are a burden, especially East and central African countries [26][27][28][29], in Ethiopia, mortalities from Malaria is current too high in either among citizens or migrants [8,30], and similar for tuberculosis [31,32].…”