Volume 68, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


As part of an effort to assess antimalarial drug resistance in Peru, we carried out 14-day efficacy trials of chloroquine (CQ; 25 mg/kg) and sulfadoxine-pyrimethamine (SP; 25 mg/kg of the sulfadoxine component) for the treatment of uncomplicated infections at three sites on the northern coast of Peru. Mefloquine (MQ; 15 mg/kg) also was evaluated at one site. The results from all three sites were similar. Of the 53 patients treated with CQ, 58.5% had RII/RIII responses. No RIII failures were observed among the 112 patients who received SP, but 4.5% and 1.8%, respectively, had RII and RI responses. All 33 patients treated with MQ showed a sensitive response. Early treatment failures were observed in 27.1% of the CQ patients but in no patients receiving SP or MQ. Late treatment failures were seen in 59.3% of the CQ patients and 6.4% of the SP patients but in none of those treated with MQ. Based on these findings and because of concern about the potential for development of resistance if SP were used alone, the National Malaria Control Program is planning a change in malaria treatment policy to SP-artesunate combination therapy for this region of the country.


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  1. Aramburú J, Ramal C, Witzig R, 1999. Malaria reemergence in the Peruvian Amazon Region. Emerg Inf Dis 5 : 209–215. [Google Scholar]
  2. Ministerio de Salud, Programa de Control de la Malaria y Otras Enfermedades Metaxénicas (2000). Lima, Peru.
  3. Navitsky RC, Witzig RS, Quintana Zurita J, Rios M, Aramburú Guarda JS, Gilman RH, Shankar AH, 1997. In vivo resistance of Plasmodium falciparum to pyrimethamine/ sulfadoxine in children of the Amazon Region of Peru. Am J Trop Med Hyg 57 (Suppl) : 229. [Google Scholar]
  4. Magill AJ, Garcia C, Solari L, Ylquimiche L, Vasquez M, Carey C, Calampa C, Llanos-Cuentas A, 1999. Therapeutic efficacy of pyrimethamine-sulfadoxine in the Peruvian Amazon. Am J Trop Med Hyg 61 (Suppl) : 285. [Google Scholar]
  5. Stennies GM, Marquiño W, Pardavé B, Roper M, Cabezas C, Kolczak M, Pieniazek N, Kublin JG, Carrillo C, Magill A, Plowe C, Ruebush TK, 1999. Efficacy and molecular epidemiology of chloroquine and sulfadoxine-pyrimethamine for the treatment of uncomplicated Plasmodium falciparum infections in the Peruvian Amazon. Am J Trop Med Hyg 61 (Suppl) : 291. [Google Scholar]
  6. Ministerio de Salud, (2000) Política Nacional de Medicamentos para el Control de la Malaria en el Perú, Lima, Peru.
  7. Pan American Health Organization, 1998. Evaluation of the therapeutic efficacy of drugs for the treatment of uncomplicated Plasmodium falciparum malaria in the Americas. OPS/ HCP/HCT/113/98. Washington, DC.
  8. Lemeshow S, Tabor S, 1991. Lot quality assurance sampling: single- and double- sampling plans. World Health Stat Q 44 : 115–132. [Google Scholar]
  9. Bruce-Chwatt LJ, 1986. Chemotherapy of Malaria. Second edition. World Health Organization Monograph Series No. 27. Geneva: World Health Organization, pp 261.
  10. Comer RD, Young MD, Porter JA, Gauld JR, Merritt W, 1968. Chloroquine resistance in Plasmodium falciparum malaria on the Pacific Coast of Colombia. Am J Trop Med Hyg 17 : 795–799. [Google Scholar]
  11. Osorio LE, Giraldo LE, Grajales LF, Arriaga AL, Andrade AL, Ruebush TK, Barat LM, 1999. Assessment of the therapeutic response of Plasmodium falciparum to chloroquine and sulfadoxine-pyrimethamine in an area of low malaria transmission in Colombia. Am J Trop Med Hyg 61 : 968–972. [Google Scholar]
  12. Nwanyanwu OC, Ziba C, Macheso A, Kazembe P, 2000. Efficacy of sulphadoxine-pyrimethamine for acute uncomplicated malaria due to Plasmodium falciparum in Malawian children under five years old. Trop Med Int Health 5 : 355–358. [Google Scholar]
  13. White NJ, 1992. Antimalarial drug resistance: the pace quickens. J Antimicrob Chemother 30 : 571–585. [Google Scholar]
  14. de Souza JM, 1983. A phase II clinical trial of mefloquine in Brazilian male subjects. Bull WHO 61 : 815–820. [Google Scholar]
  15. Cardoso BS, Dourado HV, Pinheiro MCN, Crescente JAB, Amoras WW, Baena J, Saraty S, 1996. Estudo da eficácia e tolerância do artesunato oral isolado e em associação com mefloquina no tratamento da malária falciparum não complicada em área endêmica do Pará. Brasil. Ref Soc Bras Med Trop 29 : 251–257. [Google Scholar]
  16. Cerutti C, Durlacher RR, de Alencar FEC, Segurado AAC, Pang LW, 1999. In vivo efficacy of mefloquine for the treatment of falciparum malaria in Brazil. J Infect Dis 180 : 2077–2080. [Google Scholar]
  17. Bloland PB, Ettling M, 1999. Making malaria-treatment policy in the face of drug resistance. Ann Trop Med Parasitol 93 : 5–23. [Google Scholar]
  18. Bloland PB, Kazembe PN, Oloo AJ, Himonga B, Barat LM, Ruebush TK, 1998. Chloroquine in Africa: critical assessment and recommendations for monitoring and evaluating chloroquine therapy efficacy in sub-Saharan Africa. Trop Med Internat Health 3 : 543–552. [Google Scholar]
  19. Barat LM, Himonga B, Nkunika S, Ettling M, Ruebush TK, Kapelwa W, Bloland PB, 1998. A systematic approach to the development of a rational malaria treatment policy in Zambia. Trop Med Internat Health 3 : 535–542. [Google Scholar]
  20. Bloland PB, Lackritz EM, Kazembe PN, Were JBO, Steketee R, Campbell CC, 1993. Beyond chloroquine: implications of drug resistance for evaluating malaria therapy efficacy and treatment policy in Africa. J Infect Dis 167 : 932–937. [Google Scholar]

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  • Received : 20 Apr 2002
  • Accepted : 23 Sep 2002

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