Malária por Plasmodium falciparum. Análise quadrienal, durante 12 anos, da eficácia do tratamento com quinino

The efficacy of quinine for the treatment of falciparum malaria was studied by quadriennal analysis of the medical records of 454 patients admitted to the HDT-GO from 1983 to 1994 and treated with identical doses of quinine alone for 7 days. In the quadriennium from 1983 to 1986, 98.4% of the patients became negative by the 5th day of treatment and 8% presented recurrence (R1); from 1987 to 1990, only 72.9% became negative by the 5th day of treatment, 1.4% remained positive until the 7th day (R2) and 9.7% presented recurrence (R1); from 1991 to 1994, 70.1% became negative by the 5th day of treatment, 3.5% remained positive until the 7th day (R2) and 20% presented recurrence (R1).The increase in parasite clearance time with failure up to the 7th day of treatment (R2) and the increase in recurrence (R1) show that P. falciparum is developing resistance to quinine in the region under study.