Predictors of Sowunmi et al for Failure of Chloroquine Therapy of Plasmodium falciparum Malaria in a Region of Chloroquine Resistance

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