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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, Eusebio Víctor Saute, Francisco Mayor Aparicio, Alfredo Gabriel Alonso, Pedro Bassat Orellana, Quique Aide, Pedro Carlos Paulino |
Keywords: | Malària Moçambic Malaria Mozambique |
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: www.clinicalTrials.gov NCT02698748. |
Note: | Reproducció del document publicat a: http://dx.doi.org/10.1038/s41598-017-01365-4 |
It is part of: | Scientific Reports, 2017, vol. 7, num. 1, p. 1356 |
URI: | http://hdl.handle.net/2445/110933 |
Related resource: | http://dx.doi.org/10.1038/s41598-017-01365-4 |
ISSN: | 2045-2322 |
Appears in Collections: | Articles publicats en revistes (ISGlobal) |
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galatas2017_2527.pdf | 1.49 MB | Adobe PDF | View/Open |
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