Gametocitemia en malaria por Plasmodium falciparum tratada con amodiaquina o artesunato
Palabras clave:
malaria/ terapia, malaria falciparum, Plasmodium falciparum, antipalúdicos, amodiaquina, sulfadoxina, pirimetamina, Artemisia annua
Resumen
Introducción. Las relaciones de la gametocitemia de Plasmodium falciparum con el tratamiento antipalúdico han sido poco estudiadas en América.
Objetivo. Describir relaciones de la gametocitemia falciparum con el tratamiento con amodiaquina-sulfadoxina-pirimetamina, artesunato-sulfadoxina-pirimetamina o amodiaquina-artesunato.
Materiales y métodos. Se usó un diseño experimental, aleatorio, no balanceado, no ciego. El seguimiento fue de 21 a 28 días. La eficacia terapéutica se clasificó según el protocolo de la Organización Mundial de la Salud, 1998.
Resultados.
Se evaluaron 241 pacientes en Turbo, El Bagre y Zaragoza (Antioquia, Colombia). El esquema de amodiaquina-sulfadoxina-pirimetamina tuvo igual eficacia que el de artesunato-sulfadoxina-pirimetamina y amodiaquina-artesunato para controlar las fallas terapéuticas el día 21. Hubo cuatro fallas (1,66%). El esquema de amodiaquina-sulfadoxina-pirimetamina fue menos eficaz que los tratamientos con artesunato para reducir la presencia de gametocitos. Al séptimo día, ninguno de los tres tratamientos había eliminado totalmente los gametocitos. La mayoría (56%) de nuestros pacientes no tenía gametocitos antes del tratamiento y nunca los desarrolló. El tiempo para eliminar los gametocitos que se tenían al iniciar el tratamiento no fue mayor cuando la gametocitemia inicial era mayor.
Conclusión.Los tres tratamientos fueron iguales en cuanto a eficacia terapéutica e incapacidad de eliminar los gametocitos en siete días.
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2. Eichner M, Diebner HH, Molineaux L, Collins WE, Jeffery GM, Dietz K. Genesis, sequestration and survival of Plasmodium falciparum gametocytes: parameter estimates from fitting a model to malariatherapy data. Trans R Soc Trop Med Hyg. 2001; 95: 497-501.
3. Robert V, Boudin C. Biologie de la transmission homme-moustique du Plasmodium. Bull Soc Pathol Exot. 2003; 96: 6-20.
4. Field JW, Shute PG. The microscopic diagnostic of human malaria. In: A morphological study of the erythrocytic parasites. Kuala Lumpur: Government Press; 1956. p. 142.
5. Talman AM, Domarle O, McKenzie FE, Ariey F, Robert V. Gametocytogenesis: the puberty of Plasmodium falciparum. Malar J. 2004; 3: 24.
6. Rogers NJ, Hall BS, Obiero J, Targett GA, Sutherland CJ. A model for sequestration of the transmission stages of Plasmodium falciparum: adhesion of gametocyte-infected erythrocytes to human bone marrow cells. Infect Immun. 2000; 68: 3455-62. 7. Lensen A, Bril A, van de Vegte M, van Gemert GJ, Eling W, Sauerwein R. Plasmodium falciparum: infectivity of cultured, synchronized gametocytes to mosquitoes. Exp Parasitol. 1999; 91: 101-3.
8. Sinden RE, Smalley ME. Gametocytogenesis of Plasmodium falciparum in vitro: the cell-cycle. Parasitology. 1979; 79: 277-96.
9. Smalley ME, Sinden RE. Plasmodium falciparum gametocytes their longevity and infectivity. Parasitology. 1977; 74: 1-8.
10. Drakeley C, Sutherland C, Bousema JT, Sauerwein RW, Targett GA. The epidemiology of Plasmodium falciparum gametocytes: weapons of mass dispersion. Trends Parasitol. 2006; 22: 424-30.
11. Carter R, Miller LH. Evidence for environmental modulation of gametocytogenesis in Plasmodium falciparum in continuous culture. Bull World Health Organ. 1979; 57 ( Suppl.1): 37-52.
12. Dyer M, Day KP. Commitment to gametocytogenesis in Plasmodium falciparum. Parasitol Today. 2000; 16: 102-7.
13. Targett G, Drakeley C, Jawara M, von Seidlein L, Coleman R, Deen J, et al. Artesunate reduces but does not prevent posttreatment transmission of Plasmodium falciparum to Anopheles gambiae. J Infect Dis. 2001; 83: 1254-9.
14. Sowunmi A, Fateye BA. Plasmodium falciparum gametocytaemia in Nigerian children: before, during and after treatment with antimalarial drugs. Trop Med Int Health. 2003; 8: 783-92.
15. von Seidlein L, Drakeley C, Greenwood B, Walraven G, Targett G. Risk factors for gametocyte carriage in Gambian children. Am J Trop Med Hyg. 2001; 65: 523-7.
16. von Seidlein L, Jawara M, Coleman R, Doherty T, Walraven G, Targett G. Parasitaemia and gametocytaemia after treatment with chloroquine, pyrimethamine/sulfadoxine, and pyrimethamine/sulfadoxine combined with artesunate in young Gambians with uncomplicated malaria. Trop Med Int Health. 2001; 6: 92-8.
17. Sutherland CJ, Ord R, Dunyo S, Jawara M, Drakeley CJ, Alexander N, et al. Reduction of malaria transmission to Anopheles mosquitoes with a six-dose regimen of co-artemether. PLoS Med. 2005; 2: e92.
18. Hallett RL, Dunyo S, Ord R, Jawara M, Pinder M, Randall A, et al. Chloroquine-sulphadoxine-pyrimethamine for uncomplicated malaria in Gambian children: enhanced transmission to mosquitoes of multi-drug-resistant Plasmodium falciparum. PloS Clin Trials. 2006; 1: e15.
19. Contreras-Ochoa C, Ramsey JM. Gametocitos de Plasmodium vivax y Plasmodium falciparum: estadios olvidados en el desarrollo de vacunas. Salud Pública Mex. 2004; 46: 64-70.
20. Carmona-Fonseca J. Profilaxis primaria con primaquina para el paludismo. Revisión. Anuario Enfermedades Infecciosas (Medellín). 2004; 2: 51-84.
21. Litter M. Compendio de farmacología. Cuarta edición. Buenos Aires: El Ateneo; 1988. p. 794-805.
22. Grewal RS. Pharmacology of 8-aminoquinolines. Bull World Health Organ. 1981; 59: 397-406.
23. Ponsa N, Sattabongkot J, Kittayapong P, Eikarat N, Coleman RE. Transmission-blocking activity of tafenoquine (WR-238605) and artelinic acid against naturally circulating strains of Plasmodium vivax in Thailand. Am J Trop Med Hyg. 2003; 69: 542-7.
24. López-Antuñano FJ. Is primaquine useful and safe as true exo-erythrocytic meronticidal, hyponociticial and gametocidal antimalarial drugs? Salud Pública Mex. 1999; 41: 410-9.
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Cómo citar
1.
Carmona-Fonseca J, Arango E, Blair S. Gametocitemia en malaria por Plasmodium falciparum tratada con amodiaquina o artesunato. Biomed. [Internet]. 1 de junio de 2008 [citado 5 de abril de 2025];28(2):195-212. Disponible en: https://revistabiomedicaorg.biteca.online/index.php/biomedica/article/view/91
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