Chloroquine may be used to treat malaria in a developing country for a variety of reasons. Sowunmi et al reported findings that can be seen in children with chloroquine resistant malaria who are treated with chloroquine. The authors are from the University of Ibadan in Nigeria.

Patient selection: pediatric patient with falciparum malaria


Goal: to identify a patient who is failing chloroquine monotherapy early so that an alternative therapy can be used (39% failed therapy by day 7 or 14).


Factors associated therapeutic failure in multivariate analysis (each with an adjusted odds ratio approximately 2.1):

(1) age of the patient <= 7 years

(2) asexual parasitemia >= 100,000 per µL

(3) presence of gametocytemia

(4) enrolled > 4 years after start of the study (probably reflecting the increasing incidence of chloroquine resistance over time)


Clinical findings associated with therapeutic failure:

(1) persistent fever 1-2 days after starting therapy

(2) persistent parasitemia on Day 3

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