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Artemisinin or chloroquine for blood stage Plasmodium vivax malaria in Vietnam*
Author(s) -
Phan Giao T.,
De Vries Peter J.,
Tran Binh Q.,
Le Hung Q.,
Nguyen Nam V.,
Nguyen Thang V.,
Heisterkamp Siem H.,
Kager Piet A.
Publication year - 2002
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1046/j.1365-3156.2002.00948.x
Subject(s) - artemisinin , chloroquine , malaria , plasmodium vivax , regimen , artesunate , medicine , placebo , population , quinine , pharmacology , plasmodium falciparum , gastroenterology , biology , immunology , pathology , alternative medicine , environmental health
Summary Chloroquine‐resistant Plasmodium vivax has not yet occurred in Vietnam. The efficacy of artemisinin for P. vivax was not established. We conducted a double‐blind randomized study involving 240 inpatients with P. vivax malaria who received artemisinin (40 mg/kg over 3 days) plus placebo chloroquine (Art) or chloroquine (25 mg/kg over 3 days) plus placebo artemisinin (Chl). Patients were followed up with weekly blood smears for 28 days. In each group 113 cases were analysed. All patients recovered rapidly. The median (range) parasite clearance time of regimen Art was 24 h (8–72) and of Chl 24 h (8–64; P = 0.3). Parasites reappeared in two cases in each group on day 14, in eight cases in each group (7%) on day 16 and in 25 (23%) and 18 (16%) cases, respectively, at the end of 4‐week follow‐up ( P = 0.3). The population parasite clearance curve followed a mono‐exponential decline. The parasite reduction ratio per 48 h reproduction cycle was 2.3 × 10 4 for both regimens. We conclude that artemisinin and chloroquine are equally effective in the treatment of P. vivax infections in Vietnam. Reappearance of parasites before day 16 (7%) suggests the emergence of chloroquine resistance. Three days of artemisinin monotherapy does not prevent recrudescence.