Therapeutic efficacy of chloroquine for treatment of Plasmodium vivax malaria in shoa robit, north easterne thiopia

Abstract

Background: About 40% of all malaria infection in Ethiopia is caused by Plasmodium vivax. Chloroquine (CQ) is the first line treatment for confirmed P. vivax malaria in the country. However, chloroquine resistant P. vivax (CRPv) has started to affect the efficacy of this drug. The present study was carried out to assess the therapeutic efficacy of chloroquine for treatment of Plasmodium vivax malaria in Shoa Robit, North-East Ethiopia. Methods: An in vivo drug efficacy study was conducted in Shoa Robit from October 2013 to February 2014. Eighty-seven patients with microscopically confirmed P. vivax mono-infection seeking treatment at Shoa Robit Health Centre during the study period, aged between 1 and 65 years, were recruited and treated with a 25mg/kg chloroquine, administered for three consecutive days. Socio-demographic and selected clinical information were collected using semi structured and pre-tested questionnaire. Blood smears were prepared and examined for checking parasite clearance and/or recurrence of parasitaemia and clinical examination was performed at allfollow-up visits. Haemoglobin (Hgb) was measured using microhematocrit technique. Percentages, frequencies, Kaplan-Meier survival probability analysis and statistical associations were computed. P-value of <0.05 was considered statistically significant. Results: Of the total of eighty seven patients included in the study, four of them were excluded due to P. falciparum infection during the follow up and seven cases were loss to follow-up. From the seventy six study participants, who completed their 28 day follow up, five (6.6%) were with early treatment failure (ETF). Forty four (50.6% ) of the study participants were febrile on day of admission and sixty three (72.4%) had history of fever before admission.Geometric mean parasite count of the study participants was 8723.9 /μl. Mean hematocrit value was 35.45%. Conclusion: This study shows probable emergence of chloroquine resistance / treatment failure in P. vivax malaria in Shoa Robit Town, North East, Ethiopia. Regular monitoring and periodic evaluation of the efficacy of this antimalarial drug in systematically selected sentinel sites is recommended.