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...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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American Society of Tropical Medicine and Hygiene
2016
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| _version_ | 1826311796554727424 |
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| author | Thuan, PD Ca, NTN Toi, PV Nhien, NTT Thanh, NV Anh, ND Phu, NH Thai, CQ Thai, LH Hoa, NT Dong, LT Loi, MA Son, DH Khanh, TTN Dolecek, C Nhan, HT Wolbers, M Thwaites, G Farrar, J White, NJ Hien, TT |
| author_facet | Thuan, PD Ca, NTN Toi, PV Nhien, NTT Thanh, NV Anh, ND Phu, NH Thai, CQ Thai, LH Hoa, NT Dong, LT Loi, MA Son, DH Khanh, TTN Dolecek, C Nhan, HT Wolbers, M Thwaites, G Farrar, J White, NJ Hien, TT |
| author_sort | Thuan, PD |
| collection | OXFORD |
| 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. |
| first_indexed | 2024-03-07T08:16:32Z |
| format | Journal article |
| id | oxford-uuid:03c239f4-eff4-40bb-aeb8-71805a049b2f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:16:32Z |
| publishDate | 2016 |
| publisher | American Society of Tropical Medicine and Hygiene |
| record_format | dspace |
| spelling | oxford-uuid:03c239f4-eff4-40bb-aeb8-71805a049b2f2024-01-10T12:33:37ZA randomized comparison of chloroquine versus dihydroartemisinin-piperaquine for the treatment of Plasmodium vivax infection in VietnamJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:03c239f4-eff4-40bb-aeb8-71805a049b2fEnglishSymplectic Elements at OxfordAmerican Society of Tropical Medicine and Hygiene2016Thuan, PDCa, NTNToi, PVNhien, NTTThanh, NVAnh, NDPhu, NHThai, CQThai, LHHoa, NTDong, LTLoi, MASon, DHKhanh, TTNDolecek, CNhan, HTWolbers, MThwaites, GFarrar, JWhite, NJHien, TTA 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. |
| spellingShingle | Thuan, PD Ca, NTN Toi, PV Nhien, NTT Thanh, NV Anh, ND Phu, NH Thai, CQ Thai, LH Hoa, NT Dong, LT Loi, MA Son, DH Khanh, TTN Dolecek, C Nhan, HT Wolbers, M Thwaites, G Farrar, J White, NJ Hien, TT 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 |
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