title: Clinical efficacy of chloroquine versus artemether-lumefantrine for Plasmodium vivax treatment in Thailand.
abstract: Chloroquine remains the drug of choice for the treatment of vivax malaria in Thailand. Mixed infections of falciparum and vivax malaria are also common in South-East Asia. Laboratory confirmation of malaria species is not generally available. This study aimed to find alternative regimens for treating both malaria species by using falciparum antimalarial drugs. From June 2004 to May 2005, 98 patients with Plasmodium vivax were randomly treated with either artemether-lumefantrine (n = 47) or chloroquine (n = 51). Both treatments were followed by 15 mg of primaquine over 14 days. Adverse events and clinical and parasitological outcomes were recorded and revealed similar in both groups. The cure rate was 97.4% for the artemether-lumefantrine treated group and 100% for the chloroquine treated group. We concluded that the combination of artemether-lumefantrine and primaquine was well tolerated, as effective as chloroquine and primaquine, and can be an alternative regimen for treatment of vivax malaria especially in the event that a mixed infection of falciparum and vivax malaria could not be ruled out.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand. tmsks@mahidol.ac.th
authors.forename: Srivicha
authors.initials: S
authors.lastname: Krudsood
authors.forename: Noppadon
authors.initials: N
authors.lastname: Tangpukdee
authors.forename: Sant
authors.initials: S
authors.lastname: Muangnoicharoen
authors.forename: Vipa
authors.initials: V
authors.lastname: Thanachartwet
authors.forename: Nutthanej
authors.initials: N
authors.lastname: Luplertlop
authors.forename: Siripan
authors.initials: S
authors.lastname: Srivilairit
authors.forename: Polrat
authors.initials: P
authors.lastname: Wilairatana
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kano
authors.forename: Pascal
authors.initials: P
authors.lastname: Ringwald
authors.forename: Sornchai
authors.initials: S
authors.lastname: Looareesuwan
mesh_terms: D000293:Adolescent; D000368:Aged; D000818:Animals; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D000077549:Artemether; D037621:Artemisinins / Q000009:adverse effects / Q000627:therapeutic use*; D002738:Chloroquine / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005449:Fluorenes / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D000078102:Lumefantrine; D016780:Malaria, Vivax / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018512:Parasitemia; D010966:Plasmodium vivax / Q000187:drug effects; D011319:Primaquine / Q000627:therapeutic use; D013785:Thailand; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004983:Ethanolamines; D005449:Fluorenes; D002738:Chloroquine; D000077549:Artemether; D000078102:Lumefantrine; D011319:Primaquine