Therapeutic Responses of @entity3965 Malaria to XXXX and Primaquine Treatment in Northeastern Myanmar.

@entity1 @entity3965 @entity281 @entity507 @entity5895 @entity311 @entity503
UNASSIGNED: Chloroquine-primaquine (CQ-PQ) continues to be the frontline therapy for radical cure of @entity3965 @entity311 . Emergence of CQ-resistant (CQR) @entity3965 parasites requires shifting to @entity507 combination therapies (ACTs), which imposes a significant financial, logistical, and safety burden. Monitoring therapeutic efficacy of CQ is thus important. Here we evaluated therapeutic efficacy of CQ-PQ for @entity3965 @entity311 in northeast Myanmar. We recruited 587 @entity1 with @entity3965 mono- @entity281 attending local @entity311 clinics during 2012-2013. These @entity1 received three daily doses of CQ at a total dose of 24 mg base/kg body weight and an 8-day PQ treatment (0.375 mg/kg/day) commencing at the same time as first CQ dose. Of the 401 @entity1 who finished 28-day follow-up, the cumulative incidence of recurrent @entity5895 was 5.20% (95% CI, 3.04%-7.36%). Among 361 (61%) @entity1 finishing 42-day follow-up, the cumulative incidence of recurrent blood stage @entity281 reached 7.98% (95% CI, 5.20%-10.76%). The cumulative risk of gametocyte carriage at day 28 and 42 was 2.21% (95% CI, 0.78%-3.64%) and 3.93% (95% CI, 1.94%-5.92%), respectively. Interestingly, all 15 @entity1 with recurrent gametocytemias were associated with concurrent asexual stages. Genotyping of recurrent parasites at the merozoite surface protein 3a locus among 12 @entity1 with recurrent @entity5895 within 28 days revealed that 10 of these were the same genotype as day 0, suggesting of recrudescence or relapse. Similar studies in 70 @entity1 in the same area in 2007 showed no recurrent @entity5895 within 28 days. Sensitivity to @entity503 of @entity3965 in northeastern Myanmar may be deteriorating.
