云南省西双版纳恶性疟爆发区氯喹的疗效评价

目的　对云南省使用氯喹治疗失败进行调查研究 ,为制定合理的抗疟药物使用原则提供依据。　方法　采用WHO在低、中度恶性疟流行区 2 8天氯喹疗效评价方法。患者年龄≥ 6个月 ,无疟原虫密度和体温限制 ,服药后第1、2、3、4、7、14、2 1、2 8和 35天观察患者的临床症状和疟原虫携带情况。　结果　有 6 2例患者确认为感染单纯恶性疟原虫、间日疟原虫和混合疟原虫 ,其中 5 2例单纯恶性疟患者被纳入研究对象。总治疗失败率为 40 .7% ,其中早期治疗失败率为 1.8% ,晚期治疗失败率为 38.9%。　结论　当地单纯氯喹治疗单纯恶性疟感染者失败率明显高于WHO提出的2 5 % ,应停止单用氯喹治疗恶性疟。治疗失败与疟原虫密度无关联性。

Assessment of Therapeutic Efficacy of Chloroquine Against Falciparum Malaria in an Outbreak Area in Xishuangbanna,Yunnan

OBJECTIVE: To investigate the failure of treatment with chloroquine in Yunnan in order to help formulate adequate antimalarial drug policy. METHODS: A World Health Organization 28-day in vivo test on therapeutic response for uncomplicated falciparum malaria in area with low or moderate transmission was adopted. Patients of age > or = 6 months old were admitted without limitation in density of parasitaemia and body temperature. Clinical and parasitological observation was conducted for patients on day 0, 1, 2, 3, 4, 7, 14, 21, 28 and 35. RESULTS: Of 62 patients identified as malaria cases infected by Plasmodium falciparum only, Plasmodium vivax only or by both species, 52 cases infected by Plasmodium falciparum only were included in the study. The overall treatment failure rate was 40.7%, with early treatment failure (ETF) rate of 1.8% and late treatment failure rate (LTF) of 38.9%. CONCLUSION: The treatment failure rate was much higher than the rate of 25% recommended by WHO. It is suggested that use of single chloroquine should be stopped in the treatment of falciparum malaria cases in such area. No relationship was found between the failure rate and the density of malaria parasites.