Abstract
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Tropical Pediatrics |
| Vol/bind | 51 |
| Udgave nummer | 3 |
| Sider (fra-til) | 149-53 |
| Antal sider | 4 |
| ISSN | 0142-6338 |
| DOI | |
| Status | Udgivet - 2005 |
Bibliografisk note
Keywords: Administration, Oral; Antimalarials; Child; Child, Preschool; Chloroquine; Cohort Studies; Confidence Intervals; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Resistance, Microbial; Female; Follow-Up Studies; Ghana; Humans; Malaria; Male; Microbial Sensitivity Tests; Odds Ratio; Probability; Retrospective Studies; Risk Assessment; Treatment OutcomeAdgang til dokumentet
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I: Journal of Tropical Pediatrics, Bind 51, Nr. 3, 2005, s. 149-53.
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
}
TY - JOUR
T1 - Pretreatment blood concentrations of chloroquine in patients with malaria infection: relation to response to treatment
AU - Quashie, Neils Ben
AU - Akanmori, Bartholomew D
AU - Goka, Bamenla Q
AU - Ofori-Adjei, David
AU - Kurtzhals, Jørgen
N1 - Keywords: Administration, Oral; Antimalarials; Child; Child, Preschool; Chloroquine; Cohort Studies; Confidence Intervals; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Resistance, Microbial; Female; Follow-Up Studies; Ghana; Humans; Malaria; Male; Microbial Sensitivity Tests; Odds Ratio; Probability; Retrospective Studies; Risk Assessment; Treatment Outcome
PY - 2005
Y1 - 2005
N2 - Resistance of Plasmodium falciparum to chloroquine has been reported in many areas in Ghana. Most of these reports, which are from hospital-based studies, indicate RI and RII rather than RIII type of resistance. Since high pretreatment levels of chloroquine have also been measured in patients with malaria infection in Ghana, we hypothesized that the 'added effect' of the pretreatment ingested drug to the full dose given at the hospital may be responsible for the low proportion of RIII type of resistance observed. To ascertain this, pretreatment blood levels of chloroquine were correlated with treatment outcomes in 231 paediatric malaria patients, referred to a major hospital in Ghana. The rate of parasite clearance and prevalence of recrudescence, 14 days post-treatment, were determined for each patient. Results from this study showed no correlation between pretreatment chloroquine levels and day 0 parasitaemia. Two hundred and seven patients (89.6 per cent) had parasites that were sensitive to chloroquine whilst 24 (10.4 per cent) had resistant parasites. Of the latter group 17, six, and one patients had P. falciparum parasites, which were resistant at RI, RII and RIII levels, respectively. Seventy-five per cent of the patients without any detectable pretreatment blood chloroquine had parasites that were sensitive to chloroquine whilst 89.8 per cent, 98 per cent, and 100 per cent with pretreatment blood chloroquine concentration ranges of 0.5--100.5 ng/ml, 100.5--200 ng/ml, and >200 ng/ml, respectively, had chloroquine-sensitive parasites. An inverse relationship was thus observed between pretreatment blood chloroquine concentration and the degree of resistance in this study. We conclude that pre-hospital treatment ingested chloroquine contributes significantly to the resolution of malaria in children in Ghana, in the presence of chloroquine resistance.
AB - Resistance of Plasmodium falciparum to chloroquine has been reported in many areas in Ghana. Most of these reports, which are from hospital-based studies, indicate RI and RII rather than RIII type of resistance. Since high pretreatment levels of chloroquine have also been measured in patients with malaria infection in Ghana, we hypothesized that the 'added effect' of the pretreatment ingested drug to the full dose given at the hospital may be responsible for the low proportion of RIII type of resistance observed. To ascertain this, pretreatment blood levels of chloroquine were correlated with treatment outcomes in 231 paediatric malaria patients, referred to a major hospital in Ghana. The rate of parasite clearance and prevalence of recrudescence, 14 days post-treatment, were determined for each patient. Results from this study showed no correlation between pretreatment chloroquine levels and day 0 parasitaemia. Two hundred and seven patients (89.6 per cent) had parasites that were sensitive to chloroquine whilst 24 (10.4 per cent) had resistant parasites. Of the latter group 17, six, and one patients had P. falciparum parasites, which were resistant at RI, RII and RIII levels, respectively. Seventy-five per cent of the patients without any detectable pretreatment blood chloroquine had parasites that were sensitive to chloroquine whilst 89.8 per cent, 98 per cent, and 100 per cent with pretreatment blood chloroquine concentration ranges of 0.5--100.5 ng/ml, 100.5--200 ng/ml, and >200 ng/ml, respectively, had chloroquine-sensitive parasites. An inverse relationship was thus observed between pretreatment blood chloroquine concentration and the degree of resistance in this study. We conclude that pre-hospital treatment ingested chloroquine contributes significantly to the resolution of malaria in children in Ghana, in the presence of chloroquine resistance.
U2 - 10.1093/tropej/fmh104
DO - 10.1093/tropej/fmh104
M3 - Journal article
C2 - 15831666
SN - 0142-6338
VL - 51
SP - 149
EP - 153
JO - Journal of Tropical Pediatrics
JF - Journal of Tropical Pediatrics
IS - 3
ER -