Randomized trials of artemisinin-piperaquine, dihydroartemisinin-piperaquine phosphate and artemether-lumefantrine for the treatment of multi-drug resistant falciparum malaria in Cambodia-Thailand border area View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2011-08-10

AUTHORS

Jianping Song, Duong Socheat, Bo Tan, Suon Seila, Ying Xu, Fengzhen Ou, Sreng Sokunthea, Leap Sophorn, Chongjun Zhou, Changsheng Deng, Qi Wang, Guoqiao Li

ABSTRACT

BACKGROUND: Drug resistance of falciparum malaria is a global problem. Sulphadoxine/pyrimethamine-resistant and mefloquine-resistant strains of falciparum malaria have spread in Southeast Asia at lightning speed in 1980s-1990s, and the Cambodia-Thailand border is one of the malaria epidemic areas with the most severe forms of multi-drug resistant falciparum malaria. METHODS: Artemisinin-piperaquine (AP), dihydroartemisinin-piperaquine phosphate (DHP) and artemether-lumefantrine (AL) were used to treat 110, 55 and 55 uncomplicated malaria patients, respectively. The total dosage for adults is 1,750 mg (four tablets, twice over 24 hours) of AP, 2,880 mg (eight tablets, four times over two days) of DHP, and 3,360 mg (24 tablets, six times over three days) of AL. The 28-day cure rate, parasite clearance time, fever clearance time, and drug tolerance of patients to the three drugs were compared. All of the above methods were consistent with the current national guidelines. RESULTS: The mean parasite clearance time was similar in all three groups (66.7 ± 21.9 hrs, 65.6 ± 27.3 hrs, 65.3 ± 22.5 hrs in AP, DHP and AL groups, respectively), and there was no remarkable difference between them; the fever clearance time was also similar (31.6 ± 17.7 hrs, 34.6 ± 21.8 hrs and 36.9 ± 15.4 hrs, respectively). After following up for 28-days, the cure rate was 95.1%(97/102), 98.2%(54/55) and 82.4%(42/51); and the recrudescence cases was 4.9%(5/102), 1.8%(1/55) and 17.6%(9/51), respectively. Therefore, the statistical data showed that 28-day cure rate in AP and DHP groups was superior to AL group obviously.The patients had good tolerance to all the three drugs, and some side effects (anoxia, nausea, vomiting, headache and dizziness) could be found in every group and they were self-limited; patients in control groups also had good tolerance to DHP and AL, there was no remarkable difference in the three groups. CONCLUSIONS: AP, DHP and AL all remained efficacious treatments for the treatment of falciparum malaria in Cambodia-Thailand border area. However, in this particular setting, the AP regimen turned out to be favourable in terms of efficacy and effectiveness, simplicity of administration, cost and compliance. TRIAL REGISTRATION: The trial was registered at Chinese Clinical Trial Register under identifier 2005L01041. More... »

PAGES

231-231

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1475-2875-10-231

DOI

http://dx.doi.org/10.1186/1475-2875-10-231

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1051779115

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21827706


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    "description": "BACKGROUND: Drug resistance of falciparum malaria is a global problem. Sulphadoxine/pyrimethamine-resistant and mefloquine-resistant strains of falciparum malaria have spread in Southeast Asia at lightning speed in 1980s-1990s, and the Cambodia-Thailand border is one of the malaria epidemic areas with the most severe forms of multi-drug resistant falciparum malaria.\nMETHODS: Artemisinin-piperaquine (AP), dihydroartemisinin-piperaquine phosphate (DHP) and artemether-lumefantrine (AL) were used to treat 110, 55 and 55 uncomplicated malaria patients, respectively. The total dosage for adults is 1,750 mg (four tablets, twice over 24 hours) of AP, 2,880 mg (eight tablets, four times over two days) of DHP, and 3,360 mg (24 tablets, six times over three days) of AL. The 28-day cure rate, parasite clearance time, fever clearance time, and drug tolerance of patients to the three drugs were compared. All of the above methods were consistent with the current national guidelines.\nRESULTS: The mean parasite clearance time was similar in all three groups (66.7 \u00b1 21.9 hrs, 65.6 \u00b1 27.3 hrs, 65.3 \u00b1 22.5 hrs in AP, DHP and AL groups, respectively), and there was no remarkable difference between them; the fever clearance time was also similar (31.6 \u00b1 17.7 hrs, 34.6 \u00b1 21.8 hrs and 36.9 \u00b1 15.4 hrs, respectively). After following up for 28-days, the cure rate was 95.1%(97/102), 98.2%(54/55) and 82.4%(42/51); and the recrudescence cases was 4.9%(5/102), 1.8%(1/55) and 17.6%(9/51), respectively. Therefore, the statistical data showed that 28-day cure rate in AP and DHP groups was superior to AL group obviously.The patients had good tolerance to all the three drugs, and some side effects (anoxia, nausea, vomiting, headache and dizziness) could be found in every group and they were self-limited; patients in control groups also had good tolerance to DHP and AL, there was no remarkable difference in the three groups.\nCONCLUSIONS: AP, DHP and AL all remained efficacious treatments for the treatment of falciparum malaria in Cambodia-Thailand border area. However, in this particular setting, the AP regimen turned out to be favourable in terms of efficacy and effectiveness, simplicity of administration, cost and compliance.\nTRIAL REGISTRATION: The trial was registered at Chinese Clinical Trial Register under identifier 2005L01041.", 
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29 schema:description BACKGROUND: Drug resistance of falciparum malaria is a global problem. Sulphadoxine/pyrimethamine-resistant and mefloquine-resistant strains of falciparum malaria have spread in Southeast Asia at lightning speed in 1980s-1990s, and the Cambodia-Thailand border is one of the malaria epidemic areas with the most severe forms of multi-drug resistant falciparum malaria. METHODS: Artemisinin-piperaquine (AP), dihydroartemisinin-piperaquine phosphate (DHP) and artemether-lumefantrine (AL) were used to treat 110, 55 and 55 uncomplicated malaria patients, respectively. The total dosage for adults is 1,750 mg (four tablets, twice over 24 hours) of AP, 2,880 mg (eight tablets, four times over two days) of DHP, and 3,360 mg (24 tablets, six times over three days) of AL. The 28-day cure rate, parasite clearance time, fever clearance time, and drug tolerance of patients to the three drugs were compared. All of the above methods were consistent with the current national guidelines. RESULTS: The mean parasite clearance time was similar in all three groups (66.7 ± 21.9 hrs, 65.6 ± 27.3 hrs, 65.3 ± 22.5 hrs in AP, DHP and AL groups, respectively), and there was no remarkable difference between them; the fever clearance time was also similar (31.6 ± 17.7 hrs, 34.6 ± 21.8 hrs and 36.9 ± 15.4 hrs, respectively). After following up for 28-days, the cure rate was 95.1%(97/102), 98.2%(54/55) and 82.4%(42/51); and the recrudescence cases was 4.9%(5/102), 1.8%(1/55) and 17.6%(9/51), respectively. Therefore, the statistical data showed that 28-day cure rate in AP and DHP groups was superior to AL group obviously.The patients had good tolerance to all the three drugs, and some side effects (anoxia, nausea, vomiting, headache and dizziness) could be found in every group and they were self-limited; patients in control groups also had good tolerance to DHP and AL, there was no remarkable difference in the three groups. CONCLUSIONS: AP, DHP and AL all remained efficacious treatments for the treatment of falciparum malaria in Cambodia-Thailand border area. However, in this particular setting, the AP regimen turned out to be favourable in terms of efficacy and effectiveness, simplicity of administration, cost and compliance. TRIAL REGISTRATION: The trial was registered at Chinese Clinical Trial Register under identifier 2005L01041.
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37 AP
38 AP regimen
39 Asia
40 Cambodia-Thailand border
41 Cambodia-Thailand border area
42 Chinese Clinical Trial Register
43 Clinical Trials Register
44 DHP
45 DHP group
46 Register
47 Southeast Asia
48 Sulphadoxine/
49 Trials Register
50 above methods
51 administration
52 adults
53 area
54 artemether-lumefantrine
55 border
56 border area
57 cases
58 clearance time
59 compliance
60 control group
61 cost
62 cure rate
63 current national guidelines
64 data
65 differences
66 dosage
67 drug resistance
68 drug tolerance
69 drugs
70 effect
71 effectiveness
72 efficacious treatment
73 efficacy
74 epidemic areas
75 falciparum malaria
76 fever clearance time
77 form
78 global problem
79 good tolerance
80 group
81 guidelines
82 identifier 2005L01041
83 lightning speed
84 malaria
85 malaria epidemic areas
86 malaria patients
87 mean parasite clearance time
88 mefloquine-resistant strains
89 method
90 multi-drug resistant falciparum malaria
91 national guidelines
92 parasite clearance time
93 particular setting
94 patients
95 phosphate
96 problem
97 randomized trials
98 rate
99 recrudescence cases
100 regimen
101 remarkable differences
102 resistance
103 resistant falciparum malaria
104 setting
105 severe form
106 side effects
107 simplicity
108 simplicity of administration
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110 statistical data
111 strains
112 terms
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114 time
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116 total dosage
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