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Four that are worth ten

Fewer chloroquine pills have the same effect as the traditional treatment against malaria

EDUARDO CESARChloroquine: just one day, instead of threeEDUARDO CESAR

After observing that men and women with malaria who did not take all the pills indicated, and even so improved or were cured, researchers from Belém raised the hypothesis that the treatment could be rethought. A team from the Evandro Chagas Institute and from the Pará Higher Education Center (Cesupa) tested this possibility, by means of a study with 132 persons contaminated with the Plasmodium vivax protozoon, who were split into two groups, without knowing if they were taking a medicine or a placebo.

The 67 patients who formed one of the groups took four pills (600 milligrams) of chloroquine – the medicine most adopted in the treatment of malaria – during one day, and a placebo on the two following days. The 65 from the other group followed the traditional treatment: chloroquine on all the three days (four tablets on the first day and three on the next two days). During the seven days, they were all given primaquine, which avoids the recurrence of malaria, a disease that recorded almost 370,000 cases in 2003, mainly in the northern region.

The results were statistically equivalent: an 88.1% cure – measured by the absence of fever – in the first group, with a placebo, and a 91.2% cure in the second, after the fourth day of treatment. “Four pills of chloroquine in a single dose, instead of ten in three days, are sufficient to treat malaria”, guarantees José Maria de Souza, a physician from the Evandro Chagas Institute and one of the authors of this work, published in the Revista do Instituto de Medicina Tropical de São Paulo (Magazine of the São Paulo Tropical Medicine Institute). According to the researcher, there are no risks of a shorter treatment increasing the resistance of the Plasmodium vivax to the medicines.

This possibility of an adjustment to the treatment of malaria is added to another, also found last year and made known in the Revista da Sociedade Brasileira de Medicina Tropical [Magazine of the Brazilian Tropical Medicine Society]. Nagib Ponteira Abdon, another researcher from the Evandro Chagas, applied the standard treatment (ten pills of chloroquine administered during three days and one of primaquine during 14 days) to 40 patients, while another 40 took four pills of chloroquine, plus two a day of primaquine, during seven days. “There was a complete cure in both groups”, explains Souza, who gave guidance on this work. According to him, the results of these studies, which could imply lower costs and less sacrifice for the patients’ health, were officially communicated to the Consultative Committee of the Ministry of Health, in which he takes part.