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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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6bfb991774b04f97b3e7944417ea6562
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spelling	oai:doaj.org-article:6bfb991774b04f97b3e7944417ea65622021-12-02T16:06:25ZIn-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies10.1038/s41598-017-01365-42045-2322https://doaj.org/article/6bfb991774b04f97b3e7944417ea65622017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-01365-4https://doaj.org/toc/2045-2322Abstract 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.Beatriz GalatasLidia NhamussuaBaltazar CandrinhoLurdes MabotePau CisteróHimanshu GuptaRegina RabinovichClara MenéndezEusebio MaceteFrancisco SauteAlfredo MayorPedro AlonsoQuique BassatPedro AideNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-10 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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
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.
format	article
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
title	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_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_sort	in-vivo efficacy of chloroquine to clear asymptomatic infections in mozambican adults: a randomized, placebo-controlled trial with implications for elimination strategies
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/6bfb991774b04f97b3e7944417ea6562
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In-Vivo Efficacy of Chloroquine to Clear Asymptomatic Infections in Mozambican Adults: A Randomized, Placebo-controlled Trial with Implications for Elimination Strategies

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