Publication: Thiamin supplementation does not reduce the frequency of adverse events after anti-malarial therapy among patients with falciparum malaria in southern Laos
Accepted Date
2014-07-09
Issued Date
2014-07-15
Copyright Date
2014
Resource Type
Language
eng
ISSN
1475-2875 (electronic)
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Mahidol University
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BioMed Central
Bibliographic Citation
Mayxay M, Khanthavong M, Cox L, Sichanthongthip O, Imwong M, Pongvongsa T, et al. Thiamin supplementation does not reduce the frequency of adverse events after anti-malarial therapy among patients with falciparum malaria in southern Laos. Malar J. 2014 Jul 15;13:275.
Suggested Citation
Mayxay, Mayfong, Khanthavong, Maniphone, Cox, Lorna, Sichanthongthip, Odai, Mallika Imwong, มัลลิกา อิ่มวงศ์, Pongvongsa, Tiengkham, Hongvanthong, Bouasy, Phompida, Samlane, Vanisaveth, Viengxay, White, Nicholas J, Newton, Paul N Thiamin supplementation does not reduce the frequency of adverse events after anti-malarial therapy among patients with falciparum malaria in southern Laos. Mayxay M, Khanthavong M, Cox L, Sichanthongthip O, Imwong M, Pongvongsa T, et al. Thiamin supplementation does not reduce the frequency of adverse events after anti-malarial therapy among patients with falciparum malaria in southern Laos. Malar J. 2014 Jul 15;13:275.. doi:10.1186/1475-2875-13-275 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/645
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Title
Thiamin supplementation does not reduce the frequency of adverse events after anti-malarial therapy among patients with falciparum malaria in southern Laos
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Abstract
Background: In a recent study one third of Lao patients presenting with uncomplicated Plasmodium falciparum
malaria had biochemical evidence of thiamin deficiency, which was associated with a higher incidence of adverse
events. Thiamin supplementation might, therefore, reduce adverse events in this population.
Methods: An exploratory, double-blind, parallel group, placebo-controlled, superiority trial of thiamin supplementation
in patients of all ages with uncomplicated and severe falciparum malaria was conducted in Xepon District, Savannakhet
Province, southern Laos. Patients were randomly assigned to either oral thiamin 10 mg/day for 7 days immediately after
standard anti-malarial treatment then 5 mg daily until day 42, or identical oral placebo.
Results: After interim analyses when 630 patients (314 in thiamin and 316 in placebo groups) had been recruited, the
trial was discontinued on the grounds of futility. On admission biochemical thiamin deficiency (alpha ≥ 25%) was
present in 27% of patients and 9% had severe deficiency (alpha > 31%). After 42 days of treatment, the frequency of
thiamin deficiency was lower in the thiamin (2%, 1% severe) compared to the placebo (11%, 3% severe) groups (p < 0.001
and p = 0.05), respectively. Except for diarrhoea, 7% in the placebo compared to 3% in the thiamin group (p = 0.04), and
dizziness on day 1 (33% vs 25%, p = 0.045), all adverse events were not significantly different between the groups (p > 0.05).
Clinical, haematological, and parasitological responses to treatment did not differ significantly between the two groups.
Conclusion: Thiamin supplementation reduced biochemical thiamin deficiency among Lao malaria patients
following anti-malarial drug treatment, but it did not reduce the frequency of adverse events after anti-malarial
therapy or have any detected clinical or parasitological impact.