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Chloroquine remains the first-line therapy for uncomplicated malaria in Indonesia. Among a series of trials of chloroquine for malaria on this archipelago conducted since 1990, we now report the highest risk of therapeutic failure yet observed. A clinical trial of standard chloroquine therapy for uncomplicated malaria at Arso PIR V in northeastern Indonesian Papua was conducted during 1995. We enrolled 104 non-immune subjects infected with Plasmodium falciparum (n = 55), P. vivax (n = 29), or P. falciparum plus P. vivax (n = 20) and administered supervised standard chloroquine therapy (10 + 10 + 5 mg/kg at 24-hour intervals). The 28-day cumulative incidence of therapeutic failure was 95% for P. falciparum, 84% for P. vivax, and 100% for mixed infections. Only one subject each for P. falciparum and P. vivax remained free of parasites at day 28. All recurrent parasitemias occurred with whole blood levels of chloroquine plus desethylchloroquine exceeding 100 ng/ml. These findings document almost complete failure of chloroquine against P. falciparum or P. vivax near the northeastern coast of Indonesian Papua.

Type

Journal article

Journal

The american journal of tropical medicine and hygiene

Publication Date

04/2003

Volume

68

Pages

416 - 420

Addresses

United States Naval Medical Research Unit No. 2, American Embassy, Jakarta, Indonesia.

Keywords

Humans, Parasitemia, Malaria, Falciparum, Malaria, Vivax, Recurrence, Chloroquine, Antimalarials, Treatment Failure, Life Tables, Risk Factors, Adolescent, Adult, Child, Child, Preschool, Indonesia