Publication: Directly-observed therapy (DOT) for the radical 14-day primaquine treatment of Plasmodium vivax malaria on the Thai-Myanmar border
Accepted Date
2010-11-01
Issued Date
2010-11-01
Copyright Date
2010
Resource Type
Language
eng
ISSN
1475-2875 (electronic)
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Takeuchi R, Lawpoolsri S, Imwong M, Kobayashi J, Kaewkungwal J, Pukrittayakamee S. et al. Directly-observed therapy (DOT) for the radical 14-day primaquine treatment of Plasmodium vivax malaria on the Thai-Myanmar border. Malar J. 2010 Nov 1;9:308.
Suggested Citation
Takeuchi, Rie, Saranath Lawpoolsri, สารนาถ ล้อพูลศรี, Mallika Imwong, มัลลิกา อิ่มวงศ์, Kobayashi, Jun, Jaranit Kaewkungwal, จรณิต แก้วกังวาล, Sasithon Pukrittayakamee, ศศิธร ผู้กฤตยาคามี, Supalap Puangsa-art, ศุภลาภ พวงสอาด, Nipon Thanyavanich, นิพนธ์ ธัญญวานิช, Wanchai Maneeboonyang, วรรณไชย มณีบุญยัง, Day, Nicholas P.J., Pratap Singhasivanon, ประตาป สิงหศิวานนท์ Directly-observed therapy (DOT) for the radical 14-day primaquine treatment of Plasmodium vivax malaria on the Thai-Myanmar border. Takeuchi R, Lawpoolsri S, Imwong M, Kobayashi J, Kaewkungwal J, Pukrittayakamee S. et al. Directly-observed therapy (DOT) for the radical 14-day primaquine treatment of Plasmodium vivax malaria on the Thai-Myanmar border. Malar J. 2010 Nov 1;9:308.. doi:10.1186/1475-2875-9-308 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/725
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Title
Directly-observed therapy (DOT) for the radical 14-day primaquine treatment of Plasmodium vivax malaria on the Thai-Myanmar border
Author(s)
Takeuchi, Rie
Saranath Lawpoolsri
สารนาถ ล้อพูลศรี
Mallika Imwong
มัลลิกา อิ่มวงศ์
Kobayashi, Jun
Jaranit Kaewkungwal
จรณิต แก้วกังวาล
Sasithon Pukrittayakamee
ศศิธร ผู้กฤตยาคามี
Supalap Puangsa-art
ศุภลาภ พวงสอาด
Nipon Thanyavanich
นิพนธ์ ธัญญวานิช
Wanchai Maneeboonyang
วรรณไชย มณีบุญยัง
Day, Nicholas P.J.
Pratap Singhasivanon
ประตาป สิงหศิวานนท์
Saranath Lawpoolsri
สารนาถ ล้อพูลศรี
Mallika Imwong
มัลลิกา อิ่มวงศ์
Kobayashi, Jun
Jaranit Kaewkungwal
จรณิต แก้วกังวาล
Sasithon Pukrittayakamee
ศศิธร ผู้กฤตยาคามี
Supalap Puangsa-art
ศุภลาภ พวงสอาด
Nipon Thanyavanich
นิพนธ์ ธัญญวานิช
Wanchai Maneeboonyang
วรรณไชย มณีบุญยัง
Day, Nicholas P.J.
Pratap Singhasivanon
ประตาป สิงหศิวานนท์
Corresponding Author(s)
Abstract
BACKGROUND: Plasmodium vivax has a dormant hepatic stage, called the hypnozoite,
which can cause relapse months after the initial attack. For 50 years, primaquine
has been used as a hypnozoitocide to radically cure P. vivax infection, but major
concerns remain regarding the side-effects of the drug and adherence to the
14-day regimen. This study examined the effectiveness of using the
directly-observed therapy (DOT) method for the radical treatment of P. vivax
malaria infection, to prevent reappearance of the parasite within the 90-day
follow-up period. Other potential risk factors for the reappearance of P. vivax
were also explored.
METHODS: A randomized trial was conducted from May 2007 to January 2009 in a low
malaria transmission area along the Thai-Myanmar border. Patients aged ≥ 3 years
diagnosed with P. vivax by microscopy, were recruited. All patients were treated
with the national standard regimen of chloroquine for three days followed by
primaquine for 14 days. Patients were randomized to receive DOT or
self-administered therapy (SAT). All patients were followed for three months to
check for any reappearance of P. vivax.
RESULTS: Of the 216 patients enrolled, 109 were randomized to DOT and 107 to SAT.
All patients recovered without serious adverse effects. The vivax reappearance
rate was significantly lower in the DOT group than the SAT group (3.4/10,000
person-days vs. 13.5/10,000 person-days, p = 0.021). Factors related to the
reappearance of vivax malaria included inadequate total primaquine dosage
received (< 2.75 mg/kg), duration of fever ≤ 2 days before initiation of
treatment, parasite count on admission ≥ 10,000/µl, multiple P. vivax-genotype
infection, and presence of P. falciparum infection during the follow-up period.
CONCLUSIONS: Adherence to the 14-day primaquine regimen is important for the
radical cure of P. vivax malaria infection. Implementation of DOT reduces the
reappearance rate of the parasite, and may subsequently decrease P. vivax
transmission in the area.