Directly observed therapy with primaquine to reduce the recurrence rate of plasmodium vivax infection along the Thai-Myanmar border

Abstract

This study was carried out from April 2005 to June 2006 to evaluate the recurrence of P. vivax malaria infection in relation to drug compliance along the Thai-Myanmar border in Ratchaburi, Thailand. Ninety-two patients with vivax malaria were sequentially assigned to 2 groups. Both groups received a standard dose of chloroquine (total dose = 2.5 g) for 3 days and primaquine (total dose = 210 mg) for 14 days. The experimental group received a full course of treatment using daily directly observed therapy (DOT) while subjects in the control group were given the medication with necessary instructions to take as self-administered therapy (SAT). Patients were followed up for 3 months on Days 14, 21, 28, 60 and 90. Five of 46 patients from the SAT group had recurrence of malaria on Days 21, 44, 60, 72 and 87. Recurrence was not observed among patients in the DOT group. Survival analysis also showed significant differences between the SAT and DOT groups (p < 0.05). The study suggests patient compliance with the 14-day primaquine treatment with DOT improve the outcome of P.vivax malaria treatment.