Therapeutic efficacy of chloroquine for treatment Of plasmodium vivax malaria among outpatients at Hossana health center, southern ethiopia

Abstract

Background: Plasmodium vivax accounts for about 44 % of all malaria infection in Ethiopia. Chloroquine is the first line treatment of Plasmodium vivax malaria in Ethiopia. However, chloroquine is first line drug used to treat P.vivax malaria in Ethiopia, some reports indicating the emergence of chloroquine resistant vivax malaria in different parts of the country. Chloroquine resistant Plasmodium vivax has been emerging in different parts of the world, and posing both health and economic impact especially in developing countries. Objective: To determine therapeutic efficacy of chloroquine for the treatment of Plasmodium vivax malaria among outpatients in Hossana Health centre, Southern Ethiopia. Methods: A one arm 28 days in vivo drug efficacy study was conducted at Hossana Health Centre from April 5 to June 25/2014. Convenient sampling technique was used to enrol 63 patients aged between 4 and 59 years with microscopically confirmed Plasmodium vivax. All patients were treated with chloroquine 25 mg/kg for three days. Recurrence of parasitaemia and clinical conditions of patients were assessed on day 1, 2, 3, 7, 14, 21, and 28 during the 28 day follow-up period. Haemoglobin level was determined on day 0, day 28 and on day of recurrence of parasitaemia by using portable spectrophotometer. Results: From 63 patients included in the study, 60 (95.2%) completed their 28 days follow up, 3 patients excluded from the study;1 patient due to vomiting of the second dose of drug, 1 patient due to Plasmodium falciparum infection and 1 patient lost to follow up the study. During enrolment, 35(53.3 %) had a history of fever and 28(46.7 %) had documented fever. The geometric mean of parasite density on day of enrolment was 3472 parasites/μl. Among these, 2 patients had recurrent parasitaemia within the 28 day follow up. Conclusion: Chloroquine was found to be efficacious (96.7%) except 2 treatment failures detected in Hossana Health Centre Southern Ethiopia This failure is most likely late parasitological failure. Recommendation: Regular monitoring of the pattern of resistance to chloroquine is needed in Plasmodium vivax malaria endemic areas of the country to take measures rapidly and effectively to control the possible spread of drug resistance