title: Vivax malaria: preliminary observations following a shorter course of treatment with artesunate plus primaquine.
abstract: The standard adult treatment regimen for Plasmodium vivax malaria is chloroquine (1500 mg over 3 d) plus primaquine (15 or 30 mg daily for 14 d), but patient compliance tends to be poor with the lengthy course. Preliminary observations are reported on the efficacy of a shorter treatment course - artesunate (200mg twice a day for 2 d) plus primaquine (22.5mg base twice a day for 7 d) - given to 28 adult patients infected with P. vivax in Viet Nam. All patients responded quickly to treatment with mean (SD) parasite and fever clearance times of 14.2 (4.0) and 18.6 (8.4) h, respectively. The high dose of primaquine was generally well tolerated, and only one patient (3.6%) had a recurrence of parasitaemia during 28 d of follow-up. As most patients infected with Southeast Asian strains of P. vivax have their first relapse within 28 d after treatment with rapidly eliminated blood schizonticides, the absence of parasitaemia in the remaining 27 patients suggests that this drug regimen was active against both blood and liver stages. Further studies are needed to confirm that this rapidly acting, short artesunate-primaquine regimen can result in better patient compliance and treatment outcomes than the chloroquine-primaquine regimen.
authors: Department of Infectious Diseases, Military Hospital 175, Ho Chi Minh City, Viet Nam.
authors: Nguyen Van Hoang
authors: NV
authors: Dao
authors: Bui Tri
authors: BT
authors: Cuong
authors: Nguyen Dang
authors: ND
authors: Ngoa
authors: Le Thi Thanh
authors: le TT
authors: Thuy
authors: Nguyen Duy
authors: ND
authors: The
authors: Dinh Ngoc
authors: DN
authors: Duy
authors: Bui
authors: B
authors: Dai
authors: Nguyen Xuan
authors: NX
authors: Thanh
authors: Marina
authors: M
authors: Chavchich
authors: Karl H
authors: KH
authors: Rieckmann
authors: Michael D
authors: MD
authors: Edstein
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D037621:Artemisinins / Q000008:administration & dosage / Q000627:therapeutic use*; D000077332:Artesunate; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016780:Malaria, Vivax / Q000097:blood / Q000188:drug therapy*; D008297:Male; D011319:Primaquine / Q000008:administration & dosage / Q000627:therapeutic use*; D055502:Secondary Prevention; D012717:Sesquiterpenes / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D000077332:Artesunate; D011319:Primaquine