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Title: In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies
Author: Galatas, Beatriz
Nhamussua, Lidia
Candrinho, Baltazar
Mabote, Lurdes
Cisteró, Pau
Gupta, Himanshu
Rabinovich, Regina
Menéndez, Clara
Macete, Eusébio
Saute, Francisco
Mayor Aparicio, Alfredo Gabriel
Alonso, Pedro
Bassat Orellana, Quique
Aide, Pedro Carlos Paulino
Keywords: Malària
Issue Date: 2-May-2017
Publisher: Nature Publishing Group
Abstract: Recent reports regarding the re-emergence of parasite sensitivity to chloroquine call for a new consideration of this drug as an interesting complementary tool in malaria elimination efforts, given its good safety profile and long half-life. A randomized (2:1), single-blind, placebo-controlled trial was conducted in Manhica, Mozambique, to assess the in-vivo efficacy of chloroquine to clear plasmodium falciparum (Pf) asymptomatic infections. Primary study endpoint was the rate of adequate and parasitological response (ACPR) to therapy on day 28 (PCR-corrected). Day 0 isolates were analyzed to assess the presence of the PfCRT-76T CQ resistance marker. A total of 52 and 27 male adults were included in the CQ and Placebo group respectively. PCR-corrected ACPR was significantly higher in the CQ arm 89.4% (95%CI 80-98%) compared to the placebo (p < 0.001). CQ cleared 49/50 infections within the first 72 h while placebo cleared 12/26 (LRT p < 0.001). The PfCRT-76T mutation was present only in one out of 108 (0.9%) samples at baseline, well below the 84% prevalence found in 1999 in the same area. This study presents preliminary evidence of a return of chloroquine sensitivity in Mozambican Pf isolates, and calls for its further evaluation in community-based malaria elimination efforts, in combination with other effective anti-malarials. TRIAL REGISTRATION: NCT02698748.
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It is part of: Scientific Reports, 2017, vol. 7, num. 1, p. 1356
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ISSN: 2045-2322
Appears in Collections:Articles publicats en revistes (ISGlobal)

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