Abstract
BackgroundChloroquine is an anti-malarial drug being used to treat Plasmodium vivax malaria cases in Ethiopia. However, emergence of chloroquine resistant strains of the parasite has challenged the current efficacy of the drug. Therefore, the aim of this study was to assess the effectiveness of chloroquine against P. vivax strains in one of the malaria endemic areas of Ethiopia, namely Halaba district, located in South Nations and Nationalities Peoples Region (SNNPR) of South EthiopiaResultsAmong 87 malaria patients enrolled in the study, only 80 of them completed the 28-days follow-up. Seven of them dropped from the study for different reasons. Among those study participants that completed their follow-up, 69 were classified under the category of adequate clinical and parasitological response (ACPR). However, the remaining 11 cases were considered as under treatment failure mainly due to recurrence of parasitemia on day 7 (four patients), day 14 (six patients), and day 21 (one patient). The age of all cases of treatment failures was found to be less than 20 years. The load of parasitemia of patients with treatment failure on day of admission (4709.4/μl) was higher than day of recurrence (372.37/μl). Parasite reduction ratio (PRR) of treatment failure cases was 12.6/μl.ConclusionThis report revealed the rise in treatment failure (13% [95% CI = 0.074 - 0.217]) as compared to earlier reports from Ethiopia. It signals the spreading of chloroquine resistant P. vivax (CRPv) strains to malaria endemic areas of Ethiopia. It is recommended that all concerned bodies should act aggressively before further expansion of the current drug resistant malaria.
Highlights
The efficacies of anti-malarial drugs have been challenged by the emergence of drug resistant strains of Plasmodium parasites
Significant numbers of clinical resistance have been reported for a long time in most parts of Asia, mainly from Indonesia [10,11,12], chloroquine resistant strains of P. vivax was not known in Ethiopia until recent years
The high prevalence of P. vivax malaria and the presence of antimalarial drug resistant P. falciparium in the study area could be an indicator for the possible emergence of chloroquine resistant P. vivax (CRPv) strains
Summary
The efficacies of anti-malarial drugs have been challenged by the emergence of drug resistant strains of Plasmodium parasites. Significant numbers of clinical resistance have been reported for a long time in most parts of Asia, mainly from Indonesia [10,11,12], chloroquine resistant strains of P. vivax was not known in Ethiopia until recent years. It has been used as the first line drug for many years for treatment of P. vivax infection. In agreement with the hypothesis, the outcome of the study showed the highest ever reported decline in the efficacy of chloroquine drug against P. vivax Except for these few reports, the nationwide prevalence of chloroquine resistant P. vivax remains poorly studied. The aim of this study was to assess the effectiveness of chloroquine against P. vivax strains in one of the malaria endemic areas of Ethiopia, namely Halaba district, located in South Nations and Nationalities Peoples Region (SNNPR) of South Ethiopia
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