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Title: A randomized comparison of chloroquine versus dihydroartemisinin-piperaquine for the treatment of plasmodium vivax infection in Vietnam
Authors: Phung Duc Thuan
Nguyen Thuy Nha Ca
Pham Van Toi
Nguyen Thanh Thuy Nhien
Ngo Viet Thanh
Nguyen Duc Anh
Nguyen Hoan Phu
Cao Quang Thai
Le Hong Thai
Nhu Thi Hoa
Le Thanh Dong
Mai Anh Loi
Do Hung Son
Tran Tinh Ngoc Khanh
Christiane Dolecek
Ho Thi Nhan
Marcel Wolbers
Guy Thwaites
Jeremy Farrar
Nicholas J. White
Tran Tinh Hien
Oxford University Clinical Research Unit
Institute of Malariology, Parasitology and Entomology
University of Oxford
Mahidol University
Keywords: Immunology and Microbiology
Issue Date: 1-Apr-2016
Citation: American Journal of Tropical Medicine and Hygiene. Vol.94, No.4 (2016), 879-885
Abstract: © Copyright 2016 by The American Society of Tropical Medicine and Hygiene. A total of 128 Vietnamese patients with symptomatic Plasmodium vivax mono-infections were enrolled in a prospective, open-label, randomized trial to receive either chloroquine or dihydroartemisinin-piperaquine (DHA-PPQ). The proportions of patients with adequate clinical and parasitological responses were 47% in the chloroquine arm (31 of 65 patients) and 66% in the DHA-PPQ arm (42 of 63 patients) in the Kaplan-Meier intention-to-treat analysis (absolute difference 19%, 95% confidence interval = 0-37%), thus establishing non-inferiority of DHA-PPQ. Fever clearance time (median 24 versus 12 hours, P = 0.02), parasite clearance time (median 36 versus 18 hours, P < 0.001), and parasite clearance half-life (mean 3.98 versus 1.80 hours, P < 0.001) were all significantly shorter in the DHA-PPQ arm. All cases of recurrent parasitemia in the chloroquine arm occurred from day 33 onward, with corresponding whole blood chloroquine concentration lower than 100 ng/mL in all patients. Chloroquine thus remains efficacious for the treatment of P. vivax malaria in southern Vietnam, but DHA-PPQ provides more rapid symptomatic and parasitological recovery.
ISSN: 00029637
Appears in Collections:Scopus 2016-2017

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