Chloroquine use improves dengue-related symptoms

Borges, Marcos Carvalho; Castro, Luiza Antunes; da Fonseca, Benedito Antonio Lopes

The study was conducted from mid-February to the first week of May of 2008. One hundred thirty-two patients were assessed for eligibility: three did not meet the inclusion criteria and 129 underwent randomisation. The patients enrolled in the study were adults (mean age, 31.64 ± 11.74 years), were predominantly female (51.2%) and reported a mean average duration of symptoms of 41.52 ± 20.16 h. Of the 129 patients, 63 were randomised to receive chloroquine and 66 were ran-domised to receive placebo. Seventy-five patients had other febrile diseases (OFDs) and 54 were confirmed to have dengue. Of the dengue patients, 17 refused to participate and 37 completed the study. Of these patients, 19 received chloroquine (mean age, 32.72 ± 11.50 years; male, 42%; duration of symptoms, 1.94 ± 0.90 day) and 18 patients received placebo (mean age, 36.74 ± 11.83 years; male, 56%; duration of symptoms, 1.56 ± 0.73 day). No patient exhibited the severe form of the disease (dengue haemorrhagic fever) and/or shock (dengue shock syndrome) (Table) . There was no significant difference between group characteristics (p > 0.05) and the most frequent symptoms were fever (100%), body ache (99.2%), headache (96.8%), joint pain (70.4%) and retro-orbital pain (68%). There was no significant difference in the duration of the disease or the intensity and days of fever among the dengue patients treated with either chloroquine or placebo. However, 12 (63%) of the dengue patients reported a substantial reduction in the intensity of pain and a great improvement in their ability to perform daily chores after taking chloroquine, whereas no improvement was reported by the patients taking placebo (p = 0.0004) (Table) . However, as this finding was not observed in the patients with OFDs, which included bacterial pneumonia, urinary tract infection and influenza, these diseases were not included in the statistical evaluation because the primary goal of this study was to examine the influence of chloroquine on the evolution of dengue disease. Interestingly, the symptoms returned immediately after the patients stopped taking the three-day chloroquine treatment, showing that chloroquine's effect was most likely due to the anti-inflammatory action of chloroquine rather than to its antiviral effect.