Publication: A randomized comparison of chloroquine versus dihydroartemisinin-piperaquine for the treatment of plasmodium vivax infection in Vietnam
Issued Date
2016-04-01
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ISSN
00029637
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2-s2.0-84963646069
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.94, No.4 (2016), 879-885
Suggested Citation
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 A randomized comparison of chloroquine versus dihydroartemisinin-piperaquine for the treatment of plasmodium vivax infection in Vietnam. American Journal of Tropical Medicine and Hygiene. Vol.94, No.4 (2016), 879-885. doi:10.4269/ajtmh.15-0740 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/40865
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Title
A randomized comparison of chloroquine versus dihydroartemisinin-piperaquine for the treatment of plasmodium vivax infection in Vietnam
Author(s)
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
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
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.