[Efficacy of dihydroartemisinin-piperaquine and artemether-lumefantrine in the treatment of uncomplicated falciparum malaria in Hainan, China].
OBJECTIVE
To assess the therapeutic efficacy of the combinations dihydroartemisinin-piperaquine and artemether-lumefantrine in treating uncomplicated falciparum malaria cases in an area with high level resistance of Plasmodium falciparum to chloroquine in Hainan Province.


METHODS
Patients aged 1 to 60 with uncomplicated P. falciparum infection and parasite density 1,000 to 200,000 parasites/microl were enrolled following an informed consent. Eligible patients were randomly assigned to 2 groups for receiving either a 3-day course of dihydroartemisinin-piperaquine (40/320 mg, DP, group A) or 6-dose course of artemether/lumefantrine (20/120 mg tablets, AL, group B) over three days. They were followed up with clinical and laboratory examinations until day 28 using standard WHO in vivo antimalarial drug test protocol.


RESULTS
Altogether 107 eligible patients were enrolled but 106 completed the study. Adequate clinical and parasitological response (ACPR) was observed in 51 (100%) and 55 (100%) cases in groups A and B respectively. The mean time of fever clearance and mean time of asexual parasite clearance were (20.99 +/- 11.38) h and (36.45 +/- 12.60) h in AL and (22.35 +/- 13.26)h and (34.99 +/- 12.28) h in DP, respectively. There was no statistical difference on the mean time of fever clearance and asexual parasite clearance between AL and DP (P > 0.05). None of the participants showed recrudescence and serious adverse effect.


CONCLUSIONS
Both combinations artemether-lumefantrine and dihydroartemisinin-piperaquine show a high cure rate and proper tolerability among the patients with uncomplicated falciparum malaria in Hainan.
Wang
Shan-Qing
SQ
Hainan Provincial Center for Disease Control and Prevention, Haikou 570203, China. wangsqkevin@hotmail.com
Christophel
Eva
E
Lin
Shi-Gan
SG
Meng
Feng
F
Hu
Xi-Min
XM
Wang
Guang-Ze
GZ
Liu
Jian
J
Zeng
Lin-Hai
LH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D000077549:Artemether; D037621:Artemisinins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002681:China; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004983:Ethanolamines / Q000627:therapeutic use; D005260:Female; D005449:Fluorenes / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D000078102:Lumefantrine; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011804:Quinolines / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult; D010879:Piperazines
D000962:Antimalarials; D000077549:Artemether; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; D000078102:Lumefantrine; D011804:Quinolines; C039060:artenimol; C034759:piperaquine; D010879:Piperazines