Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Clinical efficacy of chloroquine versus artemether-lumefantrine for Plasmodium vivax treatment in Thailand

  • Published : 2007.06.30
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Abstract

Chloroquine remains the drug of choice for the treatment of vivax malaria in Thailand. Mixed infections of falciparum and vivax malaria are also common in South-East Asia. Laboratory confirmation of malaria species is not generally available. This study aimed to find alternative regimens for treating both malaria species by using falciparum antimalarial drugs. From June 2004 to May 2005, 98 patients with Plasmodium vivax were randomly treated with either artemether-lumefantrine (n = 47) or chloroquine (n = 51). Both treatments were followed by 15 mg of primaquine over 14 days. Adverse events and clinical and parasitological outcomes were recorded and revealed similar in both groups. The cure rate was 97.4% for the artemether-lumefantrine treated group and 100% for the chloroquine treated group. We concluded that the combination of artemether-lumefantrine and primaquine was well tolerated, as effective as chloroquine and primaquine, and can be an alternative regimen for treatment of vivax malaria especially in the event that a mixed infection of falciparum and vivax malaria could not be ruled out.

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References

  1. Bair KJ (2004) Chloroquine resistance in Plasmodium vivax. Antimicrob Agents Chemother 48: 4075-4083 https://doi.org/10.1128/AAC.48.11.4075-4083.2004
  2. Baird JK, Leksana B, Masbar S, Fryauff DJ, Sutanihardja MA, Suradi, Wignall FS, Hoffman SL (1997) Diagnosis of resistance to chloroquine by Plasmodium vivax: timing of recrudescence and whole blood chloroquine level. Am J Trop Med Hyg 5 621-626
  3. Hamedi Y, Safa O, Zare S, Tan-ariya P, Kojima S, Looareesuwan S (2004) Therapeutic efficacy of artesunate in Plasmodium vivax malaria in Thailand. Southeast Asian J Trop Med Public Health 35: 570-574
  4. Hung TY, Davis TM, Ilett KF, Karunajeewa H, Aewiff S, Denis MB, Lim C, Socheat D (2004) Population pharmacokinetics of piperaquine in adults and children with uncomplicated falciparum or vivax malaria. Br J Clin Pharmacol 57: 253-262 https://doi.org/10.1046/j.1365-2125.2003.02004.x
  5. Looareesuwan S, White NJ, Chittamas S, Bunnag D, Harinasuta T (1987) High rate of Plasmodium vivax relapse following treatment of falciparum malaria in Thailand. Lancet 2: 1052-1054
  6. Looareesuwan S, Wilairatana P, Krudsood S, Singhasivanon P, Treeprasertsuk S, Bussaratid V, W Chokjindachai, Viriyavejakul P, Chalermrut K, Walsh DS, White NJ (1999) Chloroquine sensitivity of Plasmodium vivax in Thailand. Ann Trop Med Parasitol 93: 225-230 https://doi.org/10.1080/00034989958474
  7. Luxemburger C, van Vugt M, Jonathan S, McGready R, Looareesuwan S, White NJ, Nosten F (1999) Treatment of vivax malaria on the western border of Thailand. Trans R Soc Trop Med Hyg 93: 433-438 https://doi.org/10.1016/S0035-9203(99)90149-9
  8. Phan GT, de Vries PJ, Tran BQ, Le HQ, Nguyen NV, Nguyen TV, Heisterkamp SH, Kager PA (2002) Artemisinin or chloroquine for blood stage Plasmodium vivax malaria in Vietnam. Trop Med Int Health 7: 858-864 https://doi.org/10.1046/j.1365-3156.2002.00948.x
  9. Tjitra E, Baker J, Suprianto S, Cheng Q, Anstey NM (2002) Therapeutic efficacies of artesunate-sulfadoxinepyrimethamine and chloroquine-sulfadoxinepyrimethamine in vivax malaria pilot studies: relationship to Plasmodium vivax dhfr mutations. Antimicrob Agents Chemother 46: 3947-3953 https://doi.org/10.1128/AAC.46.12.3947-3953.2002
  10. Wilairatana P, Silachamroon U, Krudsood S, Singhasivanon P, Treeprasertsuk S, Bussaratid V, Phumratanaprapin W, Srivilirit S, Looareesuwan S (1999) Efficacy of primaquine regimens for primaquine-resistant Plasmodium vivax malaria in Thailand. Am J Trop Med Hyg 61: 973-977 https://doi.org/10.4269/ajtmh.1999.61.973
  11. World health Organization (2002) Monitoring antimalarial drug resistance. Geneva: WHO/CDS/CSR/EPH/ 2002.17-WHO/CDS/RBM/2002.39