Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1461-1466 |
| Journal | Clinical Infectious Diseases |
| Volume | 37 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2003 |
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Treatment of Uncomplicated Falciparum Malaria in Southern Vietnam: Can Chloroquine or Sulfadoxine-Pyrimethamine Be Reintroduced in Combination with Artesunate. / Huong, N.M.; Davis, Timothy; Cox-Singh, J.; Hewitt, S.; Toan, T.Q.; Kim, T.B.; Hanh, N.T.; Phuong, V.N.; Nhan, D.H.; Cong, L.D.
In: Clinical Infectious Diseases, Vol. 37, No. 11, 2003, p. 1461-1466.Research output: Contribution to journal › Article
TY - JOUR
T1 - Treatment of Uncomplicated Falciparum Malaria in Southern Vietnam: Can Chloroquine or Sulfadoxine-Pyrimethamine Be Reintroduced in Combination with Artesunate
AU - Huong, N.M.
AU - Davis, Timothy
AU - Cox-Singh, J.
AU - Hewitt, S.
AU - Toan, T.Q.
AU - Kim, T.B.
AU - Hanh, N.T.
AU - Phuong, V.N.
AU - Nhan, D.H.
AU - Cong, L.D.
PY - 2003
Y1 - 2003
N2 - The effectiveness of chloroquine or sulfadoxine-pyrimethamine administered with artesunate for treating uncomplicated falciparum malaria was assessed in 2 Vietnamese provinces where the sensitivity of parasites in vitro to conventional therapies had increased with the removal of drug pressure. In the province of Dac Lac, where potential malaria exposure begins at birth, 57 subjects (mean age, 9.6 years) were randomized to receive artesunate-chloroquine (group 1) or artesunate-sulfadoxine-pyrimethamine (group 2). In the province of Binh Phuoc, 66 nonimmune workers and their relatives (mean age, 24.2 years) were similarly randomized. By day 28 of follow-up, >96% of Dac Lac patients and <52% of Binh Phuoc patients in group 1 and group 2 had an in vivo response that demonstrated sensitivity to therapy. PCR-confirmed cure rates paralleled in vivo results among patients in Binh Phuoc, but PCR results identified 9 (15.7%) of the Dac Lac patients as having experienced asymptomatic, submicroscopic recrudescences. In Dac Lac, pfcrt K76T was near fixation, but infection with parasites with this mutation predicted recrudescence among group 1 patients in Binh Phuoc. Common pfdhfr mutations did not predict outcome in group 2. The successful reintroduction of conventional therapies in combination with artesunate depends on epidemiological and/or parasitological factors.
AB - The effectiveness of chloroquine or sulfadoxine-pyrimethamine administered with artesunate for treating uncomplicated falciparum malaria was assessed in 2 Vietnamese provinces where the sensitivity of parasites in vitro to conventional therapies had increased with the removal of drug pressure. In the province of Dac Lac, where potential malaria exposure begins at birth, 57 subjects (mean age, 9.6 years) were randomized to receive artesunate-chloroquine (group 1) or artesunate-sulfadoxine-pyrimethamine (group 2). In the province of Binh Phuoc, 66 nonimmune workers and their relatives (mean age, 24.2 years) were similarly randomized. By day 28 of follow-up, >96% of Dac Lac patients and <52% of Binh Phuoc patients in group 1 and group 2 had an in vivo response that demonstrated sensitivity to therapy. PCR-confirmed cure rates paralleled in vivo results among patients in Binh Phuoc, but PCR results identified 9 (15.7%) of the Dac Lac patients as having experienced asymptomatic, submicroscopic recrudescences. In Dac Lac, pfcrt K76T was near fixation, but infection with parasites with this mutation predicted recrudescence among group 1 patients in Binh Phuoc. Common pfdhfr mutations did not predict outcome in group 2. The successful reintroduction of conventional therapies in combination with artesunate depends on epidemiological and/or parasitological factors.
U2 - 10.1086/379323
DO - 10.1086/379323
M3 - Article
VL - 37
SP - 1461
EP - 1466
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 11
ER -