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...

সম্পূর্ণ বিবরণ

গ্রন্থ-পঞ্জীর বিবরন
প্রধান লেখক: Thuan, P, Ca, N, Toi, P, Nhien, N, Thanh, N, Anh, N, Phu, N, Thai, C, Thai, L, Hoa, N, Dong, L, Loi, M, Son, D, Khanh, T, Dolecek, C, Nhan, H, Wolbers, M, Thwaites, G, Farrar, J, White, N, Hien, T
বিন্যাস: Journal article
প্রকাশিত: American Society of Tropical Medicine and Hygiene 2016
_version_ 1826294180182228992
author Thuan, P
Ca, N
Toi, P
Nhien, N
Thanh, N
Anh, N
Phu, N
Thai, C
Thai, L
Hoa, N
Dong, L
Loi, M
Son, D
Khanh, T
Dolecek, C
Nhan, H
Wolbers, M
Thwaites, G
Farrar, J
White, N
Hien, T
author_facet Thuan, P
Ca, N
Toi, P
Nhien, N
Thanh, N
Anh, N
Phu, N
Thai, C
Thai, L
Hoa, N
Dong, L
Loi, M
Son, D
Khanh, T
Dolecek, C
Nhan, H
Wolbers, M
Thwaites, G
Farrar, J
White, N
Hien, T
author_sort Thuan, P
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 2024-03-07T03:41:39Z
format Journal article
id oxford-uuid:be1ab84c-f04e-4da1-97f4-4e5e037321c8
institution University of Oxford
last_indexed 2024-03-07T03:41:39Z
publishDate 2016
publisher American Society of Tropical Medicine and Hygiene
record_format dspace
spelling oxford-uuid:be1ab84c-f04e-4da1-97f4-4e5e037321c82022-03-27T05:36:48ZA randomized comparison of Chloroquine versus Dihydroartemisinin-Piperaquine for the treatment of Plasmodium vivax infection in VietnamJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:be1ab84c-f04e-4da1-97f4-4e5e037321c8Symplectic Elements at OxfordAmerican Society of Tropical Medicine and Hygiene2016Thuan, PCa, NToi, PNhien, NThanh, NAnh, NPhu, NThai, CThai, LHoa, NDong, LLoi, MSon, DKhanh, TDolecek, CNhan, HWolbers, MThwaites, GFarrar, JWhite, NHien, TA 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, P
Ca, N
Toi, P
Nhien, N
Thanh, N
Anh, N
Phu, N
Thai, C
Thai, L
Hoa, N
Dong, L
Loi, M
Son, D
Khanh, T
Dolecek, C
Nhan, H
Wolbers, M
Thwaites, G
Farrar, J
White, N
Hien, T
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
work_keys_str_mv AT thuanp arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT can arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT toip arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT nhienn arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thanhn arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT anhn arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT phun arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thaic arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thail arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT hoan arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT dongl arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT loim arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT sond arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT khanht arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT dolecekc arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT nhanh arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT wolbersm arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thwaitesg arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT farrarj arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT whiten arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT hient arandomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thuanp randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT can randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT toip randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT nhienn randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thanhn randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT anhn randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT phun randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thaic randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thail randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT hoan randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT dongl randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT loim randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT sond randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT khanht randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT dolecekc randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT nhanh randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT wolbersm randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT thwaitesg randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT farrarj randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT whiten randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam
AT hient randomizedcomparisonofchloroquineversusdihydroartemisininpiperaquineforthetreatmentofplasmodiumvivaxinfectioninvietnam