In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies
Abstract 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-control...
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| Format: | Article |
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Nature Portfolio
2017-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-017-01365-4 |
| _version_ | 1818841636969381888 |
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| author | Beatriz Galatas Lidia Nhamussua Baltazar Candrinho Lurdes Mabote Pau Cisteró Himanshu Gupta Regina Rabinovich Clara Menéndez Eusebio Macete Francisco Saute Alfredo Mayor Pedro Alonso Quique Bassat Pedro Aide |
| author_facet | Beatriz Galatas Lidia Nhamussua Baltazar Candrinho Lurdes Mabote Pau Cisteró Himanshu Gupta Regina Rabinovich Clara Menéndez Eusebio Macete Francisco Saute Alfredo Mayor Pedro Alonso Quique Bassat Pedro Aide |
| author_sort | Beatriz Galatas |
| collection | DOAJ |
| description | Abstract 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 Manhiça, 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. |
| first_indexed | 2024-12-19T04:29:14Z |
| format | Article |
| id | doaj.art-6bfb991774b04f97b3e7944417ea6562 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T04:29:14Z |
| publishDate | 2017-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-6bfb991774b04f97b3e7944417ea65622022-12-21T20:35:56ZengNature PortfolioScientific Reports2045-23222017-05-017111010.1038/s41598-017-01365-4In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination StrategiesBeatriz Galatas0Lidia Nhamussua1Baltazar Candrinho2Lurdes Mabote3Pau Cisteró4Himanshu Gupta5Regina Rabinovich6Clara Menéndez7Eusebio Macete8Francisco Saute9Alfredo Mayor10Pedro Alonso11Quique Bassat12Pedro Aide13Centro de Investigação em Saúde de Manhiça (CISM)Centro de Investigação em Saúde de Manhiça (CISM)National Malaria Control Programme (NMCP), Ministry of HealthCentro de Investigação em Saúde de Manhiça (CISM)ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de BarcelonaISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de BarcelonaISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de BarcelonaCentro de Investigação em Saúde de Manhiça (CISM)Centro de Investigação em Saúde de Manhiça (CISM)Centro de Investigação em Saúde de Manhiça (CISM)Centro de Investigação em Saúde de Manhiça (CISM)Centro de Investigação em Saúde de Manhiça (CISM)Centro de Investigação em Saúde de Manhiça (CISM)Centro de Investigação em Saúde de Manhiça (CISM)Abstract 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 Manhiça, 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.https://doi.org/10.1038/s41598-017-01365-4 |
| spellingShingle | Beatriz Galatas Lidia Nhamussua Baltazar Candrinho Lurdes Mabote Pau Cisteró Himanshu Gupta Regina Rabinovich Clara Menéndez Eusebio Macete Francisco Saute Alfredo Mayor Pedro Alonso Quique Bassat Pedro Aide In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies Scientific Reports |
| title | In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies |
| title_full | In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies |
| title_fullStr | In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies |
| title_full_unstemmed | In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies |
| title_short | In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies |
| title_sort | in vivo efficacy of chloroquine to clear asymptomatic infections in mozambican adults a randomized placebo controlled trial with implications for elimination strategies |
| url | https://doi.org/10.1038/s41598-017-01365-4 |
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