Vivax malaria in children: recurrences with standard total dose of primaquine administered in 3 vs. 7 days Malaria vivax en niños: recurrencias con dosis total estándar de primaquina administrada durante 3 frente a 7 días

• Main Author: Jaime Carmona-Fonseca
• Format: Article
• Language: Spanish
• Published: Universidad de Antioquia 2010-02-01
• Series: Iatreia
• Subjects: Cloroquina, Colombia, Eficacia, Malaria, Plasmodium vivax, Primaquina, Recurrencias maláricas
• Online Access: http://www.iatreia.udea.edu.co/index.php/iatreia/article/view/1304

<p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">Introduction: </span></strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">Worldwide, the efficacy of cloroquine-primaquine for treating acute Plasmodium vivax malarious attacks has not been thoroughly evaluated. In Latin America such studies are scarce, and in Colombia, almost nonexisting.</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">Objective: </span></strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">To assess the efficacy of two regimens for administration of primaquine in children aged less than 18 years.</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">Methodology: </span></strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">A clinical, controlled, unmasked study was carried out, with randomized administration of two primaquine regimens, namely: 0.50 mg/kg/day for 7 days (0.50-7) vs. 1.17 mg/kg/day for 3 days (1.17-3).</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">Results: </span></strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">A. Healing of the acute attack: efficacy was 100% in both groups. B. Prevention of recurrences during 120 days: recurrences occurred in 68.4% of children treated with the 1.17-3 regimen, and in 34.2% of those receiving the 0.5-7 one.</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">Conclusions: </span></strong><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">1. Proportion of recurrences during the 120 days follow-up was significantly lower (34.2%) in children receiving the 0.50-7 regimen than in those </span><span style="line-height: 200%; font-family: ";Times New Roman";,";serif";; font-size: 12pt; mso-ansi-language: EN-US;" lang="EN-US">treated with the 1.17-3 one (68.4%). The length of administration of the same total dose of primaquine influenced its efficacy against recurrences: shorter periods of administration were associated with lesser efficacy.</span></p> <p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ">Introducción: </span></strong><span style="line-height: 200%; font-family: ">se ha evaluado poco en el mundo la eficacia del tratamiento con cloroquinaprimaquina para el ataque agudo y, sobre todo, para las recurrencias del paludismo vivax en niños; esos estudios en América Latina son muy escasos y casi inexistentes en Colombia.</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ">Objetivo: </span></strong><span style="line-height: 200%; font-family: ">evaluar la eficacia de dos dosificaciones de primaquina en menores de 18 años.</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ">Materiales y métodos: </span></strong><span style="line-height: 200%; font-family: ">estudio clínico controlado, no enmascarado, con asignación aleatoria del tratamiento. Se evaluaron dos grupos según la dosis de primaquina: 0,50 mg/kg/día por 7 días (0,50-7) frente a 1,17 mg/kg/día por 3 días (1,17-3).</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ">Resultados: </span></strong><span style="line-height: 200%; font-family: ">A. Curación del ataque agudo: eficacia del 100% en los dos grupos; B. Prevención de las recurrencias durante 120 días: ocurrieron recurrencias en 68,4% de los niños tratados con el esquema 1,17-3, y en 34,2% de los que recibieron el régimen 0,50-7.</span></p><p class="MsoNormal" style="text-align: justify; line-height: 200%; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;"><strong><span style="line-height: 200%; font-family: ">Conclusiones: </span></strong><span style="line-height: 200%; font-family: ">1. La proporción de recurrencias a los 120 días en niños tratados con el esquema 0,50-7 (34,2%) fue significativamente menor que la de los niños que recibieron el régimen 1,17-3 (68,4%). 2. El tiempo de administración de una misma dosis total de primaquina influye en su eficacia contra las recurrencias: a menos días, menor eficacia.</span></p><p> </p>