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|Title:||Artemisinin combination therapy for vivax malaria|
|Authors:||Nicholas M. Douglas|
Nicholas M. Anstey
Brian J. Angus
Ric N. Price
Menzies School of Health Research
Nuffield Department of Clinical Medicine
Royal Darwin Hospital
Shoklo Malaria Research Unit
|Citation:||The Lancet Infectious Diseases. Vol.10, No.6 (2010), 405-416|
|Abstract:||Early parasitological diagnosis and treatment with artemisinin-based combination therapies (ACTs) are key components of worldwide malaria elimination programmes. In general, use of ACTs has been limited to patients with falciparum malaria whereas blood-stage infections with Plasmodium vivax are mostly still treated with chloroquine. We review the evidence for the relative benefits and disadvantages of the existing separate treatment approach versus a unified ACT-based strategy for treating Plasmodium falciparum and P vivax infections in regions where both species are endemic (co-endemic). The separate treatment scenario is justifiable if P vivax remains sensitive to chloroquine and diagnostic tests reliably distinguish P vivax from P falciparum. However, with the high number of misdiagnoses in routine practice and the rise and spread of chloroquine-resistant P vivax, there might be a compelling rationale for a unified ACT-based strategy for vivax and falciparum malaria in all co-endemic regions. Analyses of the cost-effectiveness of ACTs for both Plasmodium species are needed to assess the role of these drugs in the control and elimination of vivax malaria. © 2010 Elsevier Ltd. All rights reserved.|
|Appears in Collections:||Scopus 2006-2010|
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