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EFFICACY OF THREE CHLOROQUINE–PRIMAQUINE REGIMENS FOR TREATMENT OF PLASMODIUM VIVAX MALARIA IN COLOMBIA

Plasmodium vivax malaria is an important cause of morbidity in Central and South America. In Colombia, this is the most prevalent malaria infection, representing 75% of the reported cases. To define the efficacy of the chloroquine and primaquine regimen to eliminate hypnozoites and prevent relapses, we conducted a random controlled clinical trial of three primaquine regimens in an open-label study. We evaluated the anti-relapse efficacy of total primaquine doses of 45, 105, and 210 mg administered at a dosage of 15 mg/day in 210 adults with P. vivax infection from the northwestern region of Colombia. Cure rates for blood-stage P. vivax malaria by day 28 of follow-up were 100% in all groups. Post-treatment reappearance of parasitemia during the six months of follow-up was 45%, 36.6% and 17.6%, respectively, for each group. When compared with other groups, administration of 210 mg was a significant protection factor for reappearance of parasitemia in a malaria-endemic area.

Received February 10, 2006. Accepted for publication June 11, 2006.

Acknowledgments: We thank Patricia Rocha, Nicolas Martinez, Tania Alvarez, and the communities of Turbo and El Bagre for their participation in the study.

Financial support: This work was supported by Universidad de Antioquia and Dirección Seccional de Salud de Antioquia.

^* Address correspondence to Amanda Maestre, Grupo Malaria, Universidad de Antioquia, Calle 62 # 52–59, Medellin, Colombia. E-mail: aemaestre{at}quimbaya.udea.edu.co

Authors’ address: Gonzalo Álvarez, Juan-Gabriel Piñeros, Alberto Tobón, Alexandra Ríos, Amanda Maestre, Silvia Blair, and Jaime Carmona-Fonseca, Grupo Malaria, Universidad de Antioquia, Calle 62 # 52–59, Medellin, Colombia, Telephone: 57-4-210-6486, Fax: 57-4-2106487, E-mail: aemaestre{at}quimbaya.udea.edu.co.

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