Clinical and parasitological response to oral chloroquine and primaquine in uncomplicated human Plasmodium knowlesi infections.
Clinical and parasitological response to oral chloroquine and primaquine in uncomplicated human Plasmodium knowlesi infections.
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DOI：
10.1186/1475-2875-9-238
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发表时间：
2010-08-19
期刊：
影响因子：
3
通讯作者：
Singh B
中科院分区：
文献类型：
--
作者：
Daneshvar C;Davis TM;Cox-Singh J;Rafa'ee MZ;Zakaria SK;Divis PC;Singh B
诺氏疟原虫是人类有症状和潜在致命感染的原因之一。目前尚无评估人类诺氏疟疾感染治疗的详细寄生虫学反应以及是否出现抗疟疾耐药性的研究。在马来西亚婆罗洲沙捞越Kapit医院的连续患者中，进行了一项口服氯喹和伯氨喹治疗的前瞻性观察研究，这些患者经聚合酶链式反应(PCR)确认为诺氏肺孢子虫感染。这些患者口服氯喹三天，并在24小时口服伯氨喹连续两天，主要作为一种杀配子药物。临床和寄生虫学反应在最初的24小时内每隔6小时记录一次，每天直到出院，然后每周到第28天。以间日疟患者为对照组。在符合研究标准的96名诺氏疟疾患者中，73人被招募来评估治疗的急性反应，60人完成了28天的随访。入院时，早期滋养体、晚期滋养体、裂殖体和配子体的平均寄生期分布分别为49.5%、41.5%、4.0%和5.6%。中位退热时间为26.5[四分位数范围16-34]小时。平均驱虫时间分别为3.1(95%可信区间2.8~3.4)小时和10.3(9.4~11.4)小时。这些变化比23例间日疟患者的6.3(5.3-7.8)小时和20.9(17.6-25.9)小时更快；P=0.02)。由于氯喹的快速抗疟疾特性，而且伯喹是在氯喹24小时后给药的，因此很难评估伯喹对诺氏疟原虫的效果。经聚合酶链式反应检测，未发现诺氏肺孢子虫复发或再感染。氯喹联合伯马秦是一种廉价而高效的治疗人类非复杂诺氏疟疾感染的方法，而且没有抗药性的证据。使用包括青蒿素衍生物在内的替代抗疟疾药物的进一步研究将是可取的，以确定诺氏疟原虫的最佳管理策略。
Plasmodium knowlesi is a cause of symptomatic and potentially fatal infections in humans. There are no studies assessing the detailed parasitological response to treatment of knowlesi malaria infections in man and whether antimalarial resistance occurs. A prospective observational study of oral chloroquine and primaquine therapy was conducted in consecutive patients admitted to Kapit Hospital, Sarawak, Malaysian Borneo with PCR-confirmed single P. knowlesi infections. These patients were given oral chloroquine for three days, and at 24 hours oral primaquine was administered for two consecutive days, primarily as a gametocidal agent. Clinical and parasitological responses were recorded at 6-hourly intervals during the first 24 hours, daily until discharge and then weekly to day 28. Vivax malaria patients were studied as a comparator group. Of 96 knowlesi malaria patients who met the study criteria, 73 were recruited to an assessment of the acute response to treatment and 60 completed follow-up over 28 days. On admission, the mean parasite stage distributions were 49.5%, 41.5%, 4.0% and 5.6% for early trophozoites, late trophozoites, schizonts and gametocytes respectively. The median fever clearance time was 26.5 [inter-quartile range 16-34] hours. The mean times to 50% (PCT50) and 90% (PCT90) parasite clearance were 3.1 (95% confidence intervals [CI] 2.8-3.4) hours and 10.3 (9.4-11.4) hours. These were more rapid than in a group of 23 patients with vivax malaria 6.3 (5.3-7.8) hours and 20.9 (17.6-25.9) hours; P = 0.02). It was difficult to assess the effect of primaquine on P. knowlesi parasites, due to the rapid anti-malarial properties of chloroquine and since primaquine was administered 24 hours after chloroquine. No P. knowlesi recrudescences or re-infections were detected by PCR. Chloroquine plus primaqine is an inexpensive and highly effective treatment for uncomplicated knowlesi malaria infections in humans and there is no evidence of drug resistance. Further studies using alternative anti-malarial drugs, including artemisinin derivatives, would be desirable to define optimal management strategies for P. knowlesi.
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影响因子：
3.3
作者：
Phan, GT;de Vries, PJ;Kager, PA
通讯作者：
Kager, PA
影响因子：
3
作者：
Bronner, Ulf;Divis, Paul C. S.;Singh, Balbir
通讯作者：
Singh, Balbir
DOI：
10.1086/597414
发表时间：
2009-04-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Putaporntip C;Hongsrimuang T;Seethamchai S;Kobasa T;Limkittikul K;Cui L;Jongwutiwes S
通讯作者：
Jongwutiwes S
影响因子：
4
作者：
Cox-Singh, J;Mahayet, S;Singh, B
通讯作者：
Singh, B
DOI：
10.1016/0035-9203(52)90023-0
发表时间：
1952-01-01
影响因子：
2.2
作者：
SINGH, J;RAY, AP;NAIR, CP
通讯作者：
NAIR, CP