Publication: Efficacy of primaquine regimens for primaquine-resistant Plasmodium vivax malaria in Thailand
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Issued Date
1999-01-01
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ISSN
00029637
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2-s2.0-0033367705
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.61, No.6 (1999), 973-977
Suggested Citation
P. Wilairatana, U. Silachamroon, S. Krudsood, P. Singhasivanon, S. Treeprasertsuk, V. Bussaratid, W. Phumratanaprapin, S. Srivilirit, S. Looareesuwan Efficacy of primaquine regimens for primaquine-resistant Plasmodium vivax malaria in Thailand. American Journal of Tropical Medicine and Hygiene. Vol.61, No.6 (1999), 973-977. doi:10.4269/ajtmh.1999.61.973 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/25451
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Title
Efficacy of primaquine regimens for primaquine-resistant Plasmodium vivax malaria in Thailand
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Abstract
To define the current efficacy of Fansidar® (F. Hoffmann-La Roche Ltd., Basel Switzerland) (pyrimethamine and sulfadoxine), primaquine in a high dose, and artesunate for treating acute Plasmodium vivax malaria, we conducted a comparative clinical trial of these 3 drugs in an open-label study. Patients (15-65 years old) were assigned to 1 of 4 treatments regimens in a serial order. Ninety percent of the patients were infected at Thailand- Myanmar border. Patients in group I (n = 23) received Fansidar® (3 tablets, 75 mg of pyrimethamine and 1,500 mg of sulfadoxine, a single dose on the first day), group II (n = 23) received Fansidar® (3 tablets, 75 mg of pyrimethamine and 1,500 mg of sulfadoxine, a single dose on the first day) and then received primaquine (30 mg a day for 14 days), group III (n = 23) received primaquine (30 mg a day for 14 days), and group IV (n = 23) received artesunate (200 mg once a day for 3 days) and then primaquine (30 mg a day for 14 days). Cure rates on day 28 of follow-up were 40%, 100%, 100%, and 100% in groups I, II, II, and IV, respectively. There were 4 and 5 patients in group I showing post-treatment reappearance of parasitemia at ≤16 days and between 17 and 28 days, respectively. Patients in the other 3 groups showed negative parasitemias within 7 days after treatment. Artesunate plus primaquine (group IV) cleared parasitemia faster than the other 3 regimens. There is a high proportion of ineffectiveness of Fansidar® for treatment of P. vivax malaria and it should be no longer used for treatment of P. Vivax malaria acquired at the Thailand-Myanmar border. A high dose of primaquine is safe and effective in the treatment of P. vivax malaria during the 28-day follow-up period.