Evaluation of the effect of supervised anti-malarial treatment on recurrences of Plasmodium vivax malaria

Malaria Journal

Milena Gabriela Oliveira Silva¹  Aretha Gomes Omena²  Sheila Vitor-Silva³  André Machado Siqueira⁴  Cássio Peterka⁵  Gisely Cardoso Melo⁶  Wuelton Marcelo Monteiro⁶  Jose Diego Brito-Sousa⁶  Kelry Mazurega Oliveira Dinelly⁷  Marcus Vinícius Guimarães Lacerda⁸  Vanderson Souza Sampaio⁹  Sheila Rodovalho^1,10 

[1]Escola de Enfermagem de Manaus, Universidade Federal do Amazonas, Manaus, Brazil

[2]Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil

[3]Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil

[4]Escola de Enfermagem de Manaus, Universidade Federal do Amazonas, Manaus, Brazil

[5]Instituto Nacional de Infectologia Evandro Chagas–INI, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

[6]Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil

[7]Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil

[8]Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil

[9]Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil

[10]Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil

[11]Faculdade Metropolitana de Manaus–FAMETRO, Manaus, Brazil

[12]Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil

[13]Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil

[14]Instituto de Pesquisa Leônidas & Maria Deane, Fundação Oswaldo Cruz, Manaus, Brazil

[15]Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil

[16]Fundação de Vigilância em Saúde do Amazonas–FVS/AM, Manaus, Brazil

[17]Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil

[18]Organização Pan Americana da Saúde, Brasília, Brazil

关键词: Malaria;    Plasmodium vivax;    Supervised treatment;    Unsupervised treatment;    Recurrence;   

DOI  :  10.1186/s12936-021-03793-0

来源: Springer

【 摘 要 】

BackgroundRelapses in vivax malaria have posed great challenges for malaria control, and they also account for a great proportion of reported cases. Knowing the real effectiveness of a 7-day primaquine (PQ) scheme is crucial in order to evaluate not only the cost-effectiveness of implementing new anti-hypnozoite drugs, but also how health education strategies can guarantee better compliance and be reinforced. This study aimed to evaluate the effect of daily treatment with chloroquine and PQ supervised by health workers versus prescription without supervision.MethodsThe outcome was the passive detection of new positive thick blood smears up to 180 days, based on the official data records from the National Malaria Control Programme. The recurrences seen in the real life were, therefore, used as a surrogate for true relapses.ResultsPatients under supervised treatment had a lower risk of recurrence up to day 180 when compared to the unsupervised treatment (17.9% vs. 36.1%; p = 0.027).ConclusionsThe lack of supervision in the non-supervised group (which followed standard of care in the real life) enabled proper comparison, as consent itself would have lead to greater compliance in this group. Future studies should scale such an analysis to different settings in the Brazilian Amazon.

【 授权许可】

CC BY