Resistance to Chloroquine by Plasmodium vivax at Alor in the Lesser Sundas Archipelago in Eastern Indonesia

Authors

Inge Sutanto, Department of Parasitology, Faculty of Medicine, University of Indonesia
Sri Suprijanto, Communicable Disease Control, Ministry Health of Indonesia, Jalan Percetakan Negara No 29, Jakarta
Department of Parasitology, Faculty of Medicine, University of Andalas, Jalan Perintis Kemerdekaan, Department of Parasitology, Faculty of Medicine, University of Andalas, Jalan Perintis Kemerdekaan
Paul Manoempil, Timor Leste Asistensia Integrado Saude (TAIS), Delegasi Saude (USAID), rua Bairo Formoza, Dili, Timor Leste
J. Kevin Baird, ALERTAsia FoundationFollow

Date of this Version

2009

Citation

Am. J. Trop. Med. Hyg., 81(2), 2009, pp. 338–342

Comments

Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

Abstract

The therapeutic response to standard chloroquine therapy against Plasmodium vivax was evaluated in 36 subjects living at Alor in the Lesser Sundas Archipelago of eastern Indonesia. Chloroquine level were measured on 32 individuals, and showed evidence of adequate absorption of standard chloroquine therapy. Three subjects failed treatment by Day 2 or 3, with evidence of rising asexual parasitemia, and two others had stable parasitemia to Day 7. Ten more subjects had recurrent parasitemia by Day 14, two by Day 21, and another one by Day 28. Three subjects had recurrent parasitemia on Days 14 and 28, but with chloroquine < 100 ng/mL. Eleven subjects cleared parasitemia by Day 3 and had no recurrences up to Day 28. In summary, 28-day cumulative incidence of confirmed resistance to chloroquine was 56% of infections evaluated. Chloroquine should not be considered adequate for treatment of acute vivax malaria acquired in this region.