title: A randomized open study to assess the efficacy and tolerability of dihydroartemisinin-piperaquine for the treatment of uncomplicated falciparum malaria in Cambodia.
abstract: OBJECTIVE
  To compare the efficacy and tolerability of dihydroartemisinin-piperaquine (DHA-PQP) with that of a 3-day regimen of mefloquine and artesunate (MAS3) for the treatment of uncomplicated falciparum malaria in Cambodia.
  
  
  METHODS
  Randomized open-label non-inferiority study over 64 days.
  
  
  RESULTS
  Four hundred and sixty-four patients were included in the study. The polymerase chain reaction genotyping-adjusted cure rates on day 63 were 97.5% (95% confidence interval, CI, 93.8-99.3) for DHA-PQP and 97.5% (95% CI, 93.8-99.3) for MAS3, P = 1. There were no serious adverse events, but significantly more episodes of vomiting (P = 0.03), dizziness (P = 0.002), palpitations (P = 0.04), and sleep disorders (P = 0.03) reported in the MAS3 treatment group, consistent with the side-effect profile of mefloquine.
  
  
  CONCLUSIONS
  DHA-PQP was as efficacious as MAS3, but much better tolerated, making it more appropriate for use in a routine programme setting. This highly efficacious, safe and more affordable fixed-dose combination could become the treatment of choice for Plasmodium falciparum malaria in Cambodia.
authors.affiliation: Médecins Sans Frontières, Phnom Penh, Cambodia. b.janssens@bigfoot.com
authors.forename: B
authors.initials: B
authors.lastname: Janssens
authors.forename: M
authors.initials: M
authors.lastname: van Herp
authors.forename: L
authors.initials: L
authors.lastname: Goubert
authors.forename: S
authors.initials: S
authors.lastname: Chan
authors.forename: S
authors.initials: S
authors.lastname: Uong
authors.forename: S
authors.initials: S
authors.lastname: Nong
authors.forename: D
authors.initials: D
authors.lastname: Socheat
authors.forename: A
authors.initials: A
authors.lastname: Brockman
authors.forename: E A
authors.initials: EA
authors.lastname: Ashley
authors.forename: W
authors.initials: W
authors.lastname: Van Damme
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications / Q000453:epidemiology; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D037621:Artemisinins / Q000009:adverse effects / Q000627:therapeutic use*; D000077332:Artesunate; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D018503:Genome, Protozoan; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D016780:Malaria, Vivax / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D008875:Middle Aged; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012717:Sesquiterpenes / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D010879:Piperazines
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D015767:Mefloquine; D011804:Quinolines; D012717:Sesquiterpenes; C039060:artenimol; C034759:piperaquine; D010879:Piperazines