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A randomized comparison of chloroquine versus dihydroartemisinin-piperaquine for the treatment of Plasmodium vivax infection in Vietnam

Abstract:
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.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.4269/ajtmh.15-0740

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Publisher:
American Society of Tropical Medicine and Hygiene
Journal:
American Journal of Tropical Medicine and Hygiene More from this journal
Volume:
94
Issue:
4
Pages:
879-885
Publication date:
2016-04-06
Acceptance date:
2015-12-14
DOI:
EISSN:
1476-1645
ISSN:
0002-9637


Language:
English
Pubs id:
pubs:601385
UUID:
uuid:03c239f4-eff4-40bb-aeb8-71805a049b2f
Local pid:
pubs:601385
Source identifiers:
601385
Deposit date:
2016-03-15
ARK identifier:

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