Publication: Artemisinin resistance containment project in Thailand. II: Responses to mefloquine-artesunate combination therapy among falciparum malaria patients in provinces bordering Cambodia
Accepted Date
2012-08-23
Issued Date
2012-08-28
Copyright Date
2012
Resource Type
Language
eng
ISSN
1475-2875 (electronic)
Rights
Mahidol University
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BioMed Central
Bibliographic Citation
Satimai W, Sudathip P, Vijaykadga S, Khamsiriwatchara A, Sawang S, Potithavoranan T, et al. Artemisinin resistance containment project in
Thailand. II: responses to mefloquine-artesunate
combination therapy among falciparum malaria
patients in provinces bordering Cambodia. Malar J. 2012;11:300.
Suggested Citation
Wichai Satimai, Prayuth Sudathip, Saowanit Vijaykadga, Amnat Khamsiriwatchara, อำนาจ คำศิริวัชรา, Surasak Sawang, Thanapon Potithavoranan, Aumnuyphan Sangvichean, Delacollette, Charles, Pratap Singhasivanon, ประตาป สิงหศิวานนท์, Jaranit Kaewkungwal, จรณิต แก้วกังวาล, Saranath Lawpoolsri, สารนาถ ล้อพูลศรี Artemisinin resistance containment project in Thailand. II: Responses to mefloquine-artesunate combination therapy among falciparum malaria patients in provinces bordering Cambodia. Satimai W, Sudathip P, Vijaykadga S, Khamsiriwatchara A, Sawang S, Potithavoranan T, et al. Artemisinin resistance containment project in
Thailand. II: responses to mefloquine-artesunate
combination therapy among falciparum malaria
patients in provinces bordering Cambodia. Malar J. 2012;11:300.. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/708
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Title
Artemisinin resistance containment project in Thailand. II: Responses to mefloquine-artesunate combination therapy among falciparum malaria patients in provinces bordering Cambodia
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Abstract
BACKGROUND: The area along the Thai-Cambodian border is considered an epicenter
of anti-malarial drug resistance. Recently, parasite resistance to
artemisinin-based therapies has been reported in the area. The artemisinin
resistance containment project was initiated in November 2008, with the aim to
limit resistant parasites and eliminate malaria in this region. This study
describes the response to artemisinin-based therapy among falciparum malaria
patients in the area, using data from the malaria surveillance programmed under
the containment project.
METHODS: The study was conducted in seven provinces of Thailand along the
Thai-Cambodian border. Data of Plasmodium falciparum-positive patients during
January 2009 to December 2011 were obtained from the electronic malaria
information system (eMIS) Web-based reporting system. All P. falciparum cases
were followed for 42 days, as the routine case follow-up protocol. The
demographic characteristics of the patients were described. Statistical analysis
was performed to determine the cure rate of the current standard anti-malarial
drug regimen--mefloquine-artesunate combination therapy (MAS). The proportion of
patients who remained parasite-positive at each follow-up day was calculated. In
addition, factors related to the delayed parasite clearance on day-3
post-treatment, were explored.
RESULTS: A total of 1,709 P. falciparum-positive cases were reported during the
study period. Almost 70% of falciparum cases received MAS therapy (n = 1,174).
The majority of cases were males, aged between 31 and 50 years. The overall MAS
cure rate was > 90% over the three-year period. Almost all patients were able to
clear the parasite within 7 to 14 days post-treatment. Approximately 14% of
patients undergoing MAS remained parasite-positive on day-3. Delayed parasite
clearance was not significantly associated with patient gender, age, or
citizenship. However, delayed parasite clearance varied across the study area.
CONCLUSION: Anti-malarial drug-resistant parasites should be closely monitored in
the area along the Thai-Cambodian border. Although the MAS cure rate in this
study area was above 90%, an increasing trend of treatment failure has been
reported in neighboring parts. Effective malaria surveillance is an important
component to monitor drug-resistance in the malaria containment project