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document
Assessment of therapeutic response of Plasmodium falciparum to chloroquine and sulfadoxine-pyrimethamine in an area of low malaria transmission in Colombia . Although chloroquine ( CQ ) resistance was first reported in Colombia in 1961 and sulfadoxine-pyrimethamine ( SP ) resistance in 1981 , the frequency of treatment failures to these drugs in Colombia is unclear . A modified World Health Organization 14-day in vivo drug efficacy test for uncomplicated Plasmodium falciparum malaria in areas with intense malaria transmission was adapted to reflect the clinical and epidemiologic features of a low-intensity malaria transmission area in the Pacific Coast Region of Colombia . Patients > or =1 year of age with a parasite density > or =1,000 asexual parasites per microliter were enrolled in this study . Forty-four percent ( 24 of 54 ) of the CQ-treated patients were therapeutic failures , including 7 early treatment failures ( ETFs ) and 17 late treatment failures ( LTFs ) . Four ( 6 % ) of 67 SP-treated patients were therapeutic failures ( 2 ETFs and 2 LTFs ) . Therapeutic failure in the CQ-treated group was associated with an age < 15 years old ( P < 0.01 ) , but was not associated with initial parasite density , the presence of CQ or sulfa-containing drugs in urine , or a history of malaria . The high level of therapeutic failures to CQ detected in this study underscores the need and importance of drug efficacy evaluation in the development of a rational national antimalarial drug policy . The relatively low level of therapeutic failures to SP compared with other South American countries raises further questions regarding factors that might have prevented the rapid development of in vivo resistance to this drug combination .
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Intervention_Pharmacological
chloroquine
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Intervention_Pharmacological
sulfadoxine-pyrimethamine
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Intervention_Pharmacological
chloroquine
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Intervention_Pharmacological
sulfadoxine-pyrimethamine
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Intervention_Pharmacological
CQ-treated
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Intervention_Pharmacological
CQ-treated
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Intervention_Pharmacological
CQ
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Intervention_Pharmacological
CQ
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Outcome_Other
therapeutic
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Outcome_Other
therapeutic failures
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Outcome_Other
early treatment failures ( ETFs
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Outcome_Physical
)
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Outcome_Other
late treatment failures
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Outcome_Physical
( LTFs )
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Outcome_Other
therapeutic failures
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Outcome_Other
Therapeutic failure
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Outcome_Other
therapeutic failures
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Outcome_Other
efficacy
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Outcome_Other
therapeutic failures
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Participant_Condition
low malaria
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Participant_Age
> or =1 year of age
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Participant_Sample-size
Forty-four