RESUMO
The presence of chloroquine-resistant Plasmodium vivax malaria in the New World has been suspected but not confirmed. We report the cases of three patients who acquired vivax malaria in Guyana, South America, and for whom standard chloroquine therapy (25mg/kg) failed despite therapeutic blood levels. The optimal treatment of Chloroquine-resistant P. vivax malaria is unknown, but recent studies suggest that a combination of chloroquine (25 mg/kg) and high-dose primaquine (2.5 mg/kg over 48 hours) is effective therapy. Two of our patients had recurrences of P. vivax malaria 6-8 weeks after receiving directly observed therapy with this combination. These cases confirm the presence of chloroquine-resistant P. vivax in Guyana and emphasize the need for better treatment regimens for chloroquine-resistant and primaquine-resistant P. vivax malaria.(AU)
Assuntos
Relatos de Casos , Adulto , 21003 , Humanos , Masculino , Cloroquina/uso terapêutico , Malária Vivax/tratamento farmacológico , Plasmodium vivax/efeitos dos fármacos , Primaquina/uso terapêutico , Quimioterapia Combinada , Seguimentos , Guiana , Plasmodium vivax/isolamento & purificação , Falha de TratamentoRESUMO
A 27 year old Tanzanian female with an acute P. falciparum malaria infection failed to respond to the recommended radical Fansidar treatment. The case is classified as RII resistance because after 7 days, parasitemia clearance was not achieved. The infection was certainly acquired in Tanzania but diagnosed and treated in a non-malarious country. This is possibly the first case of Fansidar resistant falciparum malaria found sensitive to Chloroquine. Chloroquine and Primaquine effectively eradicated the P. falciparum malaria from the patient. (AU)
