1921
Volume 86, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

We conducted an open-label, randomized clinical trial to assess parasite clearance times (PCT) and the efficacy of 4 mg/kg (group 1, n = 22) and 2 mg/kg (group 2, n = 22) of oral artesunate for three days followed by artemether-lumefantrine in patients with uncomplicated malaria at Xepon Interdistrict Hospital, Savannakhet Province in southern Laos. Slides were read in duplicate. The overall mean (95% confidence interval; range) PCT in hours was 23.2 (21.2–25.3; 12–46) and 22.4 (20.3–24.5; 12–46) for the first and second microscopists, respectively ( = 0.57). Ten (23%) patients remained parasitemic on day 1 after treatment (4 [18%] in group 1 and 6 [27%] in group 2; = 0.47). No patient had patent asexual parasitemia on the second and third days of treatment. The 42-day polymerase chain reaction–corrected cure rates were 100% in both treatment groups. Serious adverse events did not develop during or after treatment in any patients. In conclusion, no evidence of resistance to artesunate was found in southern Laos.

[open-access] This is an Open Access article distributed under the terms and of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2012.11-0497
2012-03-01
2017-11-18
Loading full text...

Full text loading...

/deliver/fulltext/14761645/86/3/403.html?itemId=/content/journals/10.4269/ajtmh.2012.11-0497&mimeType=html&fmt=ahah

References

  1. Noedl H, Se Y, Schaecher K, Smith BL, Socheat D, Fukuda MM, , 2008. Artemisinin Resistance in Cambodia 1 (ARC1) Study Consortium. Evidence of artemisinin-resistant malaria in western Cambodia. N Engl J Med 359: 26192620.[Crossref]
  2. Rogers WO, Sem R, Tero T, Chim P, Lim P, Muth S, Socheat D, Ariey F, Wongsrichanalai C, , 2009. Failure of artesunate-mefloquine combination therapy for uncomplicated Plasmodium falciparum malaria in southern Cambodia. Malar J 12: 10.[Crossref]
  3. Dondorp AM, Nosten F, Yi P, Das D, Phyo AP, Tarning J, Lwin KM, Ariey F, Hanpithakpong W, Lee SJ, Ringwald P, Silamut K, Imwong M, Chotivanich K, Lim P, Herdman T, An SS, Yeung S, Singhasivanon P, Day NP, Lindegardh N, Socheat D, White NJ, , 2009. Artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med 361: 455467.[Crossref]
  4. Luxemburger C, Brockman A, Silamut K, Nosten F, van Vugt M, Gimenez F, Chongsuphajaisiddhi T, White NJ, , 1998. Two patients with falciparum malaria and poor in vivo responses to artesunate. Trans R Soc Trop Med Hyg 92: 668669.[Crossref]
  5. Carrara VI, Zwang J, Ashley EA, Price RN, Stepniewska K, Barends M, Brockman A, Anderson T, McGready R, Phaiphun L, Proux S, van Vugt M, Hutagalung R, Lwin KM, Phyo AP, Preechapornkul P, Imwong M, Pukrittayakamee S, Singhasivanon P, White NJ, Nosten F, , 2009. Changes in the treatment responses to artesunate-mefloquine on the northwestern border of Thailand during 13 years of continuous deployment. PLoS ONE 4: e4551.[Crossref]
  6. Na-Bangchang K, Ruengweerayut R, Mahamad P, Ruengweerayut K, Chaijaroenkul W, , 2010. Declining in efficacy of a three-day combination regimen of mefloquine-artesunate in a multi-drug resistance area along the Thai-Myanmar border. Malar J 9: 273.[Crossref]
  7. Stepniewska K, Ashley E, Lee SJ, Anstey N, Barnes KI, Binh TQ, D'Alessandro U, Day NP, de Vries PJ, Dorsey G, Guthmann JP, Mayxay M, Newton PN, Olliaro P, Osorio L, Price RN, Rowland M, Smithuis F, Taylor WR, Nosten F, White NJ, , 2010. In vivo parasitological measures of artemisinin susceptibility. J Infect Dis 201: 570579.[Crossref]
  8. White NJ, , 1997. Assessment of the pharmacodynamic properties of the antimalarial drugs in-vivo . Antimicrob Agents Chemother 41: 14131422.
  9. White NJ, , 2004. Antimalarial drug resistance. J Clin Invest 113: 10841092.[Crossref]
  10. World Health Organization, 2006. Guidelines for the Treatment of Malaria. Geneva: World Health Organization.
  11. Sengaloundeth S, Green MD, Fernández FM, Manolin O, Phommavong K, Insixiengmay V, Hampton CY, Nyadong L, Mildenhall DC, Hostetler D, Khounsaknalath L, Vongsack L, Phompida S, Vanisaveth V, Syhakhang L, Newton PN, , 2009. A stratified random survey of the proportion of poor quality oral artesunate sold at medicine outlets in the Lao PDR: implications for therapeutic failure and drug resistance. Malar J 8: 172.[Crossref]
  12. Mayxay M, Khanthavong M, Lindegårdh N, Keola S, Barends M, Pongvongsa T, Yapom R, Annerberg A, Phompida S, Phetsouvanh R, White NJ, Newton PN, , 2004. Randomized comparison of chloroquine plus sulphadoxine-pyrimethamine versus artesunate plus mefloquine versus artemether-lumefantrine in the treatment of uncomplicated falciparum malaria in the Lao PDR (Laos). Clin Infect Dis 39: 11391147.[Crossref]
  13. Mayxay M, Thongpraseuth V, Khanthavong M, Lindgårdh N, Barends M, Keola S, Pongvongsa T, Phompida S, Phetsouvanh R, White NJ, Newton PN, , 2006. An open, randomized comparison of artesunate plus mefloquine versus dihydroartemisinin-piperaquine for the treatment of uncomplicated falciparum malaria in the Lao People's Democratic Republic (Laos). Trop Med Int Health 11: 11571185.[Crossref]
  14. Mayxay M, Keomany S, Khanthavong M, Souvannasing P, Stepniewska K, Khomthilath T, Keola S, Pongvongsa T, Phompida S, Ubben D, Valecha N, White NJ, Newton PN, , 2010. A phase III, randomized, non-inferiority trial to assess the efficacy and safety of dihydroartemisinin-piperaquine in comparison with artesunate-mefloquine in patients with uncomplicated Plasmodium falciparum malaria in southern Laos. Am J Trop Med Hyg 83: 12211229.[Crossref]
  15. World Health Organization, 2000. Severe and complicated malaria. Trans R Soc Trop Med Hyg 94 (Suppl 1): 190.
  16. Snounou G, Zhu X, Siripoon N, Jarra W, Thaithong S, Brown KN, Viriyakosol S, , 1999. Biased distribution of msp1 and msp2 allelic variants in Plasmodium falciparum populations in Thailand. Trans R Soc Trop Med Hyg 93: 369374.[Crossref]
  17. World Health Organization, 2009. Methods and Techniques for Clinical Trials on Antimalarial Drug Efficacy: Genotyping to Identify Parasite Populations. Geneva: World Health Organization Available at: http://www.who.int/malaria/resistance
  18. World Health Organization, 2009. Method for Surveillance of Antimalarial Drug Efficacy. Geneva: World Health Organization Available at: http://www.who.int/malaria/resistance
  19. Landis JR, Koch GG, , 1997. The measurement of observer agreement for categorical data. Biometrics 33: 159174.[Crossref]
  20. Statistics of the Immigration at Lao-Cambodia Borders: Nong Nokkhiad and Dongkalor Checkpoints Khong District, Champasack Province.Unpublished Lao Immigration Office Report,2010.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2012.11-0497
Loading
/content/journals/10.4269/ajtmh.2012.11-0497
Loading

Data & Media loading...

  • Received : 01 Aug 2011
  • Accepted : 14 Oct 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error