Chloroquine-resistant Plasmodium vivax malaria in Peru

Trenton K. Ruebush, Jorge Zegarra, Javier Cairo, Ellen M. Andersen, Michael Green, Dylan R. Pillai, Wilmer Marquiño, María Huilca, Ernesto Arévalo, Coralith Garcia, Lely Solary, Kevin C. Kain

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Reports from several sites in South America suggest the presence of isolated cases of chloroquine-resistant Plasmodium vivax malaria. To investigate the possibility of chloroquine-resistant P. vivax in Peru, we conducted 28-day in vivo drug efficacy trials at three sites in the Amazon region and one site on the northern Pacific Coast between 1998 and 2001. A total of 242 patients between the ages of 2 and 60 years were enrolled (177 from the Amazon region and 65 from the northern coast). All subjects received directly observed therapy with chloroquine, 25 mg/kg, over a three-day period. On enrollment, 49% had a documented fever and 96% had a history of fever; their geometric mean parasite density was 5,129 parasites/μL. A total of 212 (88%) of the 242 subjects completed their 28-day follow-up. Four of the 177 patients from the Amazon region had a recurrence of P. vivax parasitemia on days 21 and 28 after treatment was initiated. Two of these patients had chloroquine-resistant infections, based on polymerase chain reaction-single-stranded conformational polymorphism genotyping and chloroquine-desethylchloroquine blood levels, which were ≥ 97 ng/mL at the time of the reappearance of parasitemia. None of the subjects studied on the northern Pacific Coast had recurrent parasitemia.

Original languageEnglish (US)
Pages (from-to)548-552
Number of pages5
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume69
Issue number5
StatePublished - Nov 2003
Externally publishedYes

Fingerprint

Vivax Malaria
Peru
Chloroquine
Parasitemia
Plasmodium vivax
Parasites
Fever
Directly Observed Therapy
Single-Stranded Conformational Polymorphism
South America
Recurrence
Polymerase Chain Reaction
Infection
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

Ruebush, T. K., Zegarra, J., Cairo, J., Andersen, E. M., Green, M., Pillai, D. R., ... Kain, K. C. (2003). Chloroquine-resistant Plasmodium vivax malaria in Peru. American Journal of Tropical Medicine and Hygiene, 69(5), 548-552.

Chloroquine-resistant Plasmodium vivax malaria in Peru. / Ruebush, Trenton K.; Zegarra, Jorge; Cairo, Javier; Andersen, Ellen M.; Green, Michael; Pillai, Dylan R.; Marquiño, Wilmer; Huilca, María; Arévalo, Ernesto; Garcia, Coralith; Solary, Lely; Kain, Kevin C.

In: American Journal of Tropical Medicine and Hygiene, Vol. 69, No. 5, 11.2003, p. 548-552.

Research output: Contribution to journalArticle

Ruebush, TK, Zegarra, J, Cairo, J, Andersen, EM, Green, M, Pillai, DR, Marquiño, W, Huilca, M, Arévalo, E, Garcia, C, Solary, L & Kain, KC 2003, 'Chloroquine-resistant Plasmodium vivax malaria in Peru', American Journal of Tropical Medicine and Hygiene, vol. 69, no. 5, pp. 548-552.
Ruebush TK, Zegarra J, Cairo J, Andersen EM, Green M, Pillai DR et al. Chloroquine-resistant Plasmodium vivax malaria in Peru. American Journal of Tropical Medicine and Hygiene. 2003 Nov;69(5):548-552.
Ruebush, Trenton K. ; Zegarra, Jorge ; Cairo, Javier ; Andersen, Ellen M. ; Green, Michael ; Pillai, Dylan R. ; Marquiño, Wilmer ; Huilca, María ; Arévalo, Ernesto ; Garcia, Coralith ; Solary, Lely ; Kain, Kevin C. / Chloroquine-resistant Plasmodium vivax malaria in Peru. In: American Journal of Tropical Medicine and Hygiene. 2003 ; Vol. 69, No. 5. pp. 548-552.
@article{64ceabc149514fbc8c6db4e493246295,
title = "Chloroquine-resistant Plasmodium vivax malaria in Peru",
abstract = "Reports from several sites in South America suggest the presence of isolated cases of chloroquine-resistant Plasmodium vivax malaria. To investigate the possibility of chloroquine-resistant P. vivax in Peru, we conducted 28-day in vivo drug efficacy trials at three sites in the Amazon region and one site on the northern Pacific Coast between 1998 and 2001. A total of 242 patients between the ages of 2 and 60 years were enrolled (177 from the Amazon region and 65 from the northern coast). All subjects received directly observed therapy with chloroquine, 25 mg/kg, over a three-day period. On enrollment, 49{\%} had a documented fever and 96{\%} had a history of fever; their geometric mean parasite density was 5,129 parasites/μL. A total of 212 (88{\%}) of the 242 subjects completed their 28-day follow-up. Four of the 177 patients from the Amazon region had a recurrence of P. vivax parasitemia on days 21 and 28 after treatment was initiated. Two of these patients had chloroquine-resistant infections, based on polymerase chain reaction-single-stranded conformational polymorphism genotyping and chloroquine-desethylchloroquine blood levels, which were ≥ 97 ng/mL at the time of the reappearance of parasitemia. None of the subjects studied on the northern Pacific Coast had recurrent parasitemia.",
author = "Ruebush, {Trenton K.} and Jorge Zegarra and Javier Cairo and Andersen, {Ellen M.} and Michael Green and Pillai, {Dylan R.} and Wilmer Marqui{\~n}o and Mar{\'i}a Huilca and Ernesto Ar{\'e}valo and Coralith Garcia and Lely Solary and Kain, {Kevin C.}",
year = "2003",
month = "11",
language = "English (US)",
volume = "69",
pages = "548--552",
journal = "American Journal of Tropical Medicine and Hygiene",
issn = "0002-9637",
publisher = "American Society of Tropical Medicine and Hygiene",
number = "5",

}

TY - JOUR

T1 - Chloroquine-resistant Plasmodium vivax malaria in Peru

AU - Ruebush, Trenton K.

AU - Zegarra, Jorge

AU - Cairo, Javier

AU - Andersen, Ellen M.

AU - Green, Michael

AU - Pillai, Dylan R.

AU - Marquiño, Wilmer

AU - Huilca, María

AU - Arévalo, Ernesto

AU - Garcia, Coralith

AU - Solary, Lely

AU - Kain, Kevin C.

PY - 2003/11

Y1 - 2003/11

N2 - Reports from several sites in South America suggest the presence of isolated cases of chloroquine-resistant Plasmodium vivax malaria. To investigate the possibility of chloroquine-resistant P. vivax in Peru, we conducted 28-day in vivo drug efficacy trials at three sites in the Amazon region and one site on the northern Pacific Coast between 1998 and 2001. A total of 242 patients between the ages of 2 and 60 years were enrolled (177 from the Amazon region and 65 from the northern coast). All subjects received directly observed therapy with chloroquine, 25 mg/kg, over a three-day period. On enrollment, 49% had a documented fever and 96% had a history of fever; their geometric mean parasite density was 5,129 parasites/μL. A total of 212 (88%) of the 242 subjects completed their 28-day follow-up. Four of the 177 patients from the Amazon region had a recurrence of P. vivax parasitemia on days 21 and 28 after treatment was initiated. Two of these patients had chloroquine-resistant infections, based on polymerase chain reaction-single-stranded conformational polymorphism genotyping and chloroquine-desethylchloroquine blood levels, which were ≥ 97 ng/mL at the time of the reappearance of parasitemia. None of the subjects studied on the northern Pacific Coast had recurrent parasitemia.

AB - Reports from several sites in South America suggest the presence of isolated cases of chloroquine-resistant Plasmodium vivax malaria. To investigate the possibility of chloroquine-resistant P. vivax in Peru, we conducted 28-day in vivo drug efficacy trials at three sites in the Amazon region and one site on the northern Pacific Coast between 1998 and 2001. A total of 242 patients between the ages of 2 and 60 years were enrolled (177 from the Amazon region and 65 from the northern coast). All subjects received directly observed therapy with chloroquine, 25 mg/kg, over a three-day period. On enrollment, 49% had a documented fever and 96% had a history of fever; their geometric mean parasite density was 5,129 parasites/μL. A total of 212 (88%) of the 242 subjects completed their 28-day follow-up. Four of the 177 patients from the Amazon region had a recurrence of P. vivax parasitemia on days 21 and 28 after treatment was initiated. Two of these patients had chloroquine-resistant infections, based on polymerase chain reaction-single-stranded conformational polymorphism genotyping and chloroquine-desethylchloroquine blood levels, which were ≥ 97 ng/mL at the time of the reappearance of parasitemia. None of the subjects studied on the northern Pacific Coast had recurrent parasitemia.

UR - http://www.scopus.com/inward/record.url?scp=10744221880&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744221880&partnerID=8YFLogxK

M3 - Article

C2 - 14695094

AN - SCOPUS:10744221880

VL - 69

SP - 548

EP - 552

JO - American Journal of Tropical Medicine and Hygiene

JF - American Journal of Tropical Medicine and Hygiene

SN - 0002-9637

IS - 5

ER -