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Background  Of late there have been accounts of therapeutic failure and chloroquine resistance in  Plasmodium vivax  malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine–primaquine (CQ–PQ) combined regimen in a cohort of uncomplicated  P. vivax  mono-infection.    Methods  A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection  P. vivax  malaria as per the World Health Organization’s protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks.    Results  Of a total of 125 participants recruited, 122 (97.6%) completed day 28 follow up, three (2.4%) participants were lost to follow-up. Eight patients (6.4%) were ascertained to have mixed  P. vivax  and  Plasmodium falciparum  infection by nested polymerase chain reaction test. The majority of subjects (56.8%, 71/125) became aparasitaemic on day 2 followed by 35.2% (44/125) on day 3, and 8% (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8%, 1/125) occurred on day 3 due to persistence of fever and parasitaemia.    Conclusions  CQ–PQ combined regimen remains outstandingly effective for uncomplicated  P. vivax  malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.

malaria journal

Therapeutic assessment of chloroquine–primaquine combined regimen in adult cohort of Plasmodium vivax malaria from a tertiary care hospital in southwestern India