Rosas AÁ, Milena BA, Moreno D, Vargas D, Acuña Y

Language: Spanish
References: 37
Page: 445-455
PDF size: 605.86 Kb.

ABSTRACT

Introduction: Chloroquine (CQ, 25 mg/kg in total: 10 mg/kg on the first day and 7,5 mg/kg on the second and third days) and Primaquine (PQ, 3,5 mg/kg for 14 days) are recommended for P. vivax malaria treatment. Objective: To assess antimalarial treatment prescriptions in patients with P. vivax malaria in Putumayo, Colombia. Materials and methods: Between February 2009 and February 2010, antimalarial treatment prescriptions in patients with P. vivax malaria were evaluated in ten health facilities of two municipalities (Puerto Asís and Puerto Guzmán). Appropriate prescription of CQ should include a total dose of 23,8 to 30,0 mg base/kg and appropriate prescription of PQ should include a total dose of 3,3 to 4,2 mg base/kg. An appropriate global prescription should include both appropriate total doses. Results: Prescriptions from 136 patients were evaluated, 52 through direct observations of prescription practices during patient attention, and 84 through revision of treatment records; 82 (60,3%) patients had appropriate dosage of CQ, 32 (23,5%) had under-dosage, and 22 (16,2%) had over-dosage. With respect to prescribed PQ, 79 (58,1%) patients had appropriate dosage, 17 (12,5%) had underdosage, and 40 (29,4%) had over-dosage. More than half of the global prescriptions (CQ+PQ) were inappropriate. Inappropriate prescriptions (CQ and/or PQ) were higher in patients younger than 15 years, while the under-dosage was higher in patients with weights over 60 kg. Conclusion: Poor prescriptions pose a serious problem to get effective management of P. vivax infections in Putumayo.

REFERENCES

1. Organización Mundial de la Salud. Informe sobre la salud en el mundo, 2007: un porvenir más seguro. Protección de la salud pública mundial en el siglo XXI. Ginebra: OMS; 2007.

2. Mueller I, Galinski MR, Baird JK, Carlton JM, Kochar DK, Alonso PL, et al. Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite. Lancet Infect Dis. 2009; 9: 555-566.

3. Mendis K, Sina BJ, Marchesini P, Carter R. The neglected burden of Plasmodium vivax malaria. Am J Trop Med Hyg 2001; 64: 97-106.

4. Instituto Nacional de Salud de Colombia. Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA): Consolidado Final Malaria a semana 53 (2007-2009). Bogotá: INS; 2010.

5. World Health Organization. Strategic Orientation Paper on Prevention and Control of Malaria. Geneva: WHO; 2005.

6. World Health Organization. Guidelines for the treatment of malaria, second edition. Geneva: WHO; 2010.

7. Soto J, Toledo J, Gutierrez P, Luzz M, Llinas N, Cedeno N, et al. Plasmodium vivax clinically resistant to chloroquine in Colombia. Am J Trop Med Hyg 2001; 65: 90-93.

8. Blair S, Tobón A, Echeverri M, Alvarez G, Carmona J. Adecuada respuesta clínica y parasitológica de Plasmodium vivax a la cloroquina en Colombia (Turbo, Antioquia). Infectio 2001; 6: 21-26.

9. Castillo C, Osorio L, Palma G. Assessment of therapeutic response of Plasmodium vivax and Plasmodium falciparum to chloroquine in a malaria transmission free area in Colombia. Mem Inst Oswaldo Cruz 2002; 97: 559-562.

10. Carmona-Fonseca J, Álvarez G, Blair S. Malaria por Plasmodium vivax: curación del ataque agudo con tres dosis diferentes de primaquina y dosis fija de cloroquina. Antioquia, Colombia, 2003-2004. Biomédica 2006; 26: 353-365.

11. Ministerio de la Protección Social de Colombia. Guías de promoción de la salud y prevención de enfermedades en la salud pública. Bogotá: MPS; 2007.

12. Zurovac D, Rowe AK, Ochola SA, Noor AM, Midia B, English M, et al. Predictors of the quality of health worker treatment practices for uncomplicated malaria at government health facilities in Kenya. Int J Epidemiol 2004; 33: 1080-1091.

13. Rowe AK, Hamel MJ, Flanders WD, Doutizanga R, Ndoyo J, Deming MS, et al. Predictors of correct treatment of children with fever seen at outpatient health facilities in the Central African Republic. Am J Epidemiol 2000; 151: 1029-1035.

14. Ofori-Adjei D, Arhinful DK. Effects of training on the clinical management of malaria by medical assistance in Ghana. Soc Sci Med 1996; 42:1169-1176.

15. Rowe AK, Onikpo F, Lama M, Deming MS. Risk and protective factors for two types of error in the treatment of children with fever at outpatient health facilities in Benin. Int J Epidemiol 2003; 32: 296-303.

16. Nsimba SE. Assessing prescribing and patient care indicators for children under five years old with malaria and other disease conditions in public primary health care facilities. Southeast Asian J Trop Med Public Health 2006; 37: 206-214.

17. Mannan AA, Malik EM, Ali KM. Antimalarial prescribing and dispensing practices in health centres of Khartoum state, 2003-04. East Mediterr Health J 2009; 15: 122-128.

18. World Health Organization. The use of antimalarial drugs. Report of a WHO informal consultation 13–17 November 2000. World Health Organization. Geneva; WHO. 2001.

19. Ministério da Saúde. Guia prático de tratamento da malária no Brasil. Brasilia: Ministério da Saúde; 2010.

20. Duarte EC, Pang LW, Ribeiro LC, Fontes CJ. Association of subtherapeutic dosages of a standard drug regimen with failures in preventing relapses of vivax malaria. Am J Trop Med Hyg 2001; 65: 471-476.

21. Schwartz E, Regev-Yochay G, Kurnik D. Short report: a consideration of primaquine dose adjustment for radical cure of Plasmodium vivax malaria. Am J Trop Med Hyg 2000; 62: 393-395.

22. Strengthening Pharmaceutical Systems (SPS). Informe técnico: Análisis de las prácticas de prescripción, dispensación y adherencia al tratamiento antimalárico en los países que comparten la Cuenca del Amazonas. Arlington, VA: Management Sciences for Health; 2009.

23. Goller JL, Jolley D, Ringwald P, Biggs BA. Regional differences in the response of Plasmodium vivax malaria to primaquine as anti-relapse therapy. Am J Trop Med Hyg 2007; 76: 203-207.

24. White NJ. Why is it that antimalarial drug treatments do not always work? Ann Trop Med Parasitol 1998; 92: 449-458.

25. Bloland PB, Kachur SP, Williams HA. Trends in antimalarial drug deployment in sub-Saharan Africa. J Exp Biol 2003; 206: 3761-3769.

26. Good MI, Shader RI. Lethality and behavioural side effects of chloroquine. J Clin Psychopharmacol 1982; 2: 40-47.

27. Kelly JC, Wasserman GS, Bernard WD, Schulz C, Knapp JF. Chloroquine poisoning in a child. Ann Emerg Med 1990; 19: 47-50.

28. Baird JK. Chloroquine resistance in Plasmodium vivax. Antimicrob Agents Chemother 2004; 48: 4075-4083.

29. Baird JK. Resistance to therapies for infection by Plasmodium vivax. Clin Microbiol Rev 2009; 22: 508-534.

30. Berliner RW, Earle DP, Taggart JV, Zubrod CG, Welch WJ, Conan NJ, et al. Studies on the chemotherapy of the human malarias. VI. The physiological disposition, antimalarial activity, and toxicity of several derivatives of 4-aminoquinoline. J Clin Invest 1948; 27: 98-107.

31. Wilson T, Edeson JF. Studies on the chemotherapy of malaria. III. The treatment of acute malaria with chloroquine. Med J Malaya 1954; 9: 115-131.

32. Fryauff DJ, Baird JK, Basri H, Wiady I, Purnomo, Bangs MJ, et al. Halofantrine and primaquine for radical cure of malaria in Irian Jaya, Indonesia. Ann Trop Med Parasitol 1997; 91: 7-16.

33. Wilairatana P, Silachamroon U, Krudsood S, Singhasivanon P, Treeprasertsuk S, Bussaratid V, et al. Efficacy of primaquine regimens for primaquine-resistant Plasmodium vivax malaria in Thailand. Am J Trop Med Hyg 1999; 61: 973-977.

34. Moyano M, Méndez F. Erythrocyte defects and parasitemia density in patients with Plasmodium falciparum malaria in Buenaventura, Colombia. Rev Panam Salud Publica 2005; 18: 25-32.

35. WHO. Promoting safety of medicines for children. Geneva; WHO. 2007.

36. Qingjun L, Jihui D, Laiyi T, Xiangjun Z, Jun L, Hay A, et al. The effect of drug packaging on patient’s compliance with treatment for Plasmodium vivax malaria in Cina. Bulletin of the World Health Organization 1998; 76: 21-27.

37. Yeung S. How do patients use antimalarial drugs? A review of the evidence. Trop Med Int Health 2005; 10: 121-138.