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Sci Rep. 2017 May 2;7(1):1356. doi: 10.1038/s41598-017-01365-4.

In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies.

Author information

1
Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
2
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
3
National Malaria Control Programme (NMCP), Ministry of Health, Maputo, Mozambique.
4
National Directorate of Health, Ministry of Health, Maputo, Mozambique.
5
Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique. quique.bassat@isglobal.org.
6
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain. quique.bassat@isglobal.org.
7
ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain. quique.bassat@isglobal.org.

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.

PMID:
28465550
PMCID:
PMC5430993
DOI:
10.1038/s41598-017-01365-4
[Indexed for MEDLINE]
Free PMC Article

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