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A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam

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 response...

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Autores principales: Thuan, Phung Duc, Ca, Nguyen Thuy Nha, Van Toi, Pham, Nhien, Nguyen Thanh Thuy, Thanh, Ngo Viet, Anh, Nguyen Duc, Phu, Nguyen Hoan, Thai, Cao Quang, Hong Thai, Le, Hoa, Nhu Thi, Thanh Dong, Le, Loi, Mai Anh, Son, Do Hung, Khanh, Tran Tinh Ngoc, Dolecek, Christiane, Nhan, Ho Thi, Wolbers, Marcel, Thwaites, Guy, Farrar, Jeremy, White, Nicholas J., Hien, Tran Tinh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824232/
https://www.ncbi.nlm.nih.gov/pubmed/26856909
http://dx.doi.org/10.4269/ajtmh.15-0740
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author Thuan, Phung Duc
Ca, Nguyen Thuy Nha
Van Toi, Pham
Nhien, Nguyen Thanh Thuy
Thanh, Ngo Viet
Anh, Nguyen Duc
Phu, Nguyen Hoan
Thai, Cao Quang
Hong Thai, Le
Hoa, Nhu Thi
Thanh Dong, Le
Loi, Mai Anh
Son, Do Hung
Khanh, Tran Tinh Ngoc
Dolecek, Christiane
Nhan, Ho Thi
Wolbers, Marcel
Thwaites, Guy
Farrar, Jeremy
White, Nicholas J.
Hien, Tran Tinh
author_facet Thuan, Phung Duc
Ca, Nguyen Thuy Nha
Van Toi, Pham
Nhien, Nguyen Thanh Thuy
Thanh, Ngo Viet
Anh, Nguyen Duc
Phu, Nguyen Hoan
Thai, Cao Quang
Hong Thai, Le
Hoa, Nhu Thi
Thanh Dong, Le
Loi, Mai Anh
Son, Do Hung
Khanh, Tran Tinh Ngoc
Dolecek, Christiane
Nhan, Ho Thi
Wolbers, Marcel
Thwaites, Guy
Farrar, Jeremy
White, Nicholas J.
Hien, Tran Tinh
author_sort Thuan, Phung Duc
collection PubMed
description 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.
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spelling pubmed-48242322016-04-19 A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam Thuan, Phung Duc Ca, Nguyen Thuy Nha Van Toi, Pham Nhien, Nguyen Thanh Thuy Thanh, Ngo Viet Anh, Nguyen Duc Phu, Nguyen Hoan Thai, Cao Quang Hong Thai, Le Hoa, Nhu Thi Thanh Dong, Le Loi, Mai Anh Son, Do Hung Khanh, Tran Tinh Ngoc Dolecek, Christiane Nhan, Ho Thi Wolbers, Marcel Thwaites, Guy Farrar, Jeremy White, Nicholas J. Hien, Tran Tinh Am J Trop Med Hyg Articles 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. The American Society of Tropical Medicine and Hygiene 2016-04-06 /pmc/articles/PMC4824232/ /pubmed/26856909 http://dx.doi.org/10.4269/ajtmh.15-0740 Text en ©The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Thuan, Phung Duc
Ca, Nguyen Thuy Nha
Van Toi, Pham
Nhien, Nguyen Thanh Thuy
Thanh, Ngo Viet
Anh, Nguyen Duc
Phu, Nguyen Hoan
Thai, Cao Quang
Hong Thai, Le
Hoa, Nhu Thi
Thanh Dong, Le
Loi, Mai Anh
Son, Do Hung
Khanh, Tran Tinh Ngoc
Dolecek, Christiane
Nhan, Ho Thi
Wolbers, Marcel
Thwaites, Guy
Farrar, Jeremy
White, Nicholas J.
Hien, Tran Tinh
A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam
title A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam
title_full A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam
title_fullStr A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam
title_full_unstemmed A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam
title_short A Randomized Comparison of Chloroquine versus Dihydroartemisinin–Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam
title_sort randomized comparison of chloroquine versus dihydroartemisinin–piperaquine for the treatment of plasmodium vivax infection in vietnam
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824232/
https://www.ncbi.nlm.nih.gov/pubmed/26856909
http://dx.doi.org/10.4269/ajtmh.15-0740
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