CHLOROQUINE-RESISTANT PLASMODIUM VIVAX MALARIA IN PERU

TRENTON K. RUEBUSH II Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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JORGE ZEGARRA Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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JAVIER CAIRO Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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ELLEN M. ANDERSEN Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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MICHAEL GREEN Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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DYLAN R. PILLAI Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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WILMER MARQUIÑO Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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MARÍA HUILCA Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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ERNESTO ARÉVALO Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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CORALITH GARCIA Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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LELY SOLARY Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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KEVIN C. KAIN Office of the Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U. S. Naval Medical Research Center Detachment, Lima, Peru; U. S. Naval Medical Research Center Detachment Lima, Peru; Division of Parasitic Diseases Centers, Centers for Disease Control and Prevention, Atlanta, Georgia; Tropical Disease Unit, Toronto General Hospital Toronto, Ontario, Canada; Instituto Nacional de Salud, Lima, Peru

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DOI:
https://doi.org/10.4269/ajtmh.2003.69.548
Volume/Issue:
Volume 69: Issue 5
Page(s):
548–552
Restricted access
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Reports from several sites in South America suggest the presence of isolated cases of chloroquine-resistant Plasmodium vivax malaria. To investigate the possibility of chloroquine-resistant P. vivax in Peru, we conducted 28-day in vivo drug efficacy trials at three sites in the Amazon region and one site on the northern Pacific Coast between 1998 and 2001. A total of 242 patients between the ages of 2 and 60 years were enrolled (177 from the Amazon region and 65 from the northern coast). All subjects received directly observed therapy with chloroquine, 25 mg/kg, over a three-day period. On enrollment, 49% had a documented fever and 96% had a history of fever; their geometric mean parasite density was 5,129 parasites/μL. A total of 212 (88%) of the 242 subjects completed their 28-day follow-up. Four of the 177 patients from the Amazon region had a recurrence of P. vivax parasitemia on days 21 and 28 after treatment was initiated. Two of these patients had chloroquine-resistant infections, based on polymerase chain reaction-single-stranded conformational polymorphism genotyping and chloroquine-desethylchloroquine blood levels, which were ≥97 ng/mL at the time of the reappearance of parasitemia. None of the subjects studied on the northern Pacific Coast had recurrent parasitemia.

Author Notes

Reprint requests: Trenton K. Ruebush II, U.S. Naval Medical Research Center Detachment, Unit 3800, APO AA 34031, Lima, Peru.
Copyright:
Copyright 2003 The American Society of Tropical Medicine 2003
Received:
03 Jan 2003
|
Accepted:
14 May 2003
|
Published Online:
Nov 2003
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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