Assessing drug sensitivity of Plasmodium vivax to halofantrine or choroquine in southern, central Vietnam using an extended 28-day in vivo test and polymerase chain reaction genotyping

Am J Trop Med Hyg. 2000 Jun;62(6):693-7. doi: 10.4269/ajtmh.2000.62.693.

Abstract

Chloroquine-resistant Plasmodium vivax malaria is emerging in Oceania, Asia, and Latin America. We assessed the drug sensitivity of P. vivax to chloroquine or halofantrine in two villages in southern, central Vietnam. This area has chloroquine-resistant Plasmodium falciparum but no documented chloroquine-resistant P. vivax. Standard dose chloroquine (25 mg/kg, over 48 hours) or halofantrine (8 mg/kg, 3 doses) was administered to 29 and 25 patients, respectively. End points were parasite sensitivity or resistance determined at 28 days. Of the evaluable patients, 23/23 100% (95% confidence interval [CI] 85.1-100) chloroquine and 21/24 (87.5%) (95% CI 67.6-97.3) halofantrine-treated patients were sensitive. Three halofantrine recipients had initial clearance but subsequent recurrence of their parasitemias. Genotyping of the recurrent and Day 0 parasitemias differed, suggesting either new infections or relapses of liver hypnozoites from antecedent infections. Among these Vietnamese patients, P. vivax was sensitive to chloroquine and halofantrine. Genotyping was useful for differentiating the recurrent vivax parasitemias.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Antimalarials / pharmacology*
  • Antimalarials / therapeutic use
  • Child
  • Child, Preschool
  • Chloroquine / pharmacology*
  • Chloroquine / therapeutic use
  • Drug Resistance
  • Female
  • Genotype
  • Humans
  • Malaria, Vivax / drug therapy*
  • Malaria, Vivax / parasitology
  • Male
  • Merozoite Surface Protein 1 / genetics
  • Middle Aged
  • Phenanthrenes / pharmacology*
  • Phenanthrenes / therapeutic use
  • Plasmodium vivax / classification
  • Plasmodium vivax / drug effects*
  • Plasmodium vivax / genetics
  • Polymerase Chain Reaction
  • Polymorphism, Single-Stranded Conformational
  • Vietnam

Substances

  • Antimalarials
  • Merozoite Surface Protein 1
  • Phenanthrenes
  • Chloroquine
  • halofantrine