Title:
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In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections
in Mozambican Adults: A Randomized, Placebo-controlled Trial
with Implications for Elimination Strategies
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Author:
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Galatas, Beatriz; Nhamussua, Lidia; Candrinho, Baltazar; Mabote, Lurdes; Cisteró, Pau; Gupta, Himanshu; Rabinovich, Regina; Menéndez, Clara; Macete, Eusébio; Saute, Francisco; Mayor Aparicio, Alfredo Gabriel; Alonso, Pedro; Bassat Orellana, Quique; Aide, Pedro Carlos Paulino
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Abstract:
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Recent reports regarding the re-emergence of parasite
sensitivity to chloroquine call for a new consideration of this
drug as an interesting complementary tool in malaria elimination
efforts, given its good safety profile and long half-life. A
randomized (2:1), single-blind, placebo-controlled trial was
conducted in Manhica, Mozambique, to assess the in-vivo efficacy
of chloroquine to clear plasmodium falciparum (Pf) asymptomatic
infections. Primary study endpoint was the rate of adequate and
parasitological response (ACPR) to therapy on day 28
(PCR-corrected). Day 0 isolates were analyzed to assess the
presence of the PfCRT-76T CQ resistance marker. A total of 52
and 27 male adults were included in the CQ and Placebo group
respectively. PCR-corrected ACPR was significantly higher in the
CQ arm 89.4% (95%CI 80-98%) compared to the placebo (p <
0.001). CQ cleared 49/50 infections within the first 72 h while
placebo cleared 12/26 (LRT p < 0.001). The PfCRT-76T mutation
was present only in one out of 108 (0.9%) samples at baseline,
well below the 84% prevalence found in 1999 in the same area.
This study presents preliminary evidence of a return of
chloroquine sensitivity in Mozambican Pf isolates, and calls for
its further evaluation in community-based malaria elimination
efforts, in combination with other effective anti-malarials.
TRIAL REGISTRATION: www.clinicalTrials.gov NCT02698748. |
Subject(s):
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-Malària -Moçambic -Malaria -Mozambique |
Rights:
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cc by (c) Galatas et al., 2017
http://creativecommons.org/licenses/by/3.0/es/ |
Document type:
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Article Article - Published version |
Published by:
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Nature Publishing Group
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