Clinical Efficacy of Dihydroartemisinin-Piperaquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria at the China-Myanmar Border.
Artemisinin-based combination therapies (ACTs) are currently used as the first-line therapy for uncomplicated Plasmodium falciparum malaria. However, the recent emergence and/or spread of artemisinin resistance in parts of Greater Mekong Subregion (GMS) of southeast Asia requires close monitoring of the therapeutic efficacy of ACTs. This study was conducted from March 2012 to December 2013 in four clinics and seven villages along the China-Myanmar border. A total of 109 patients with uncomplicated falciparum malaria were treated with dihydroartemisinin-piperaquine (DP) and followed up on days 1, 2, 3, 7, 14, 21, 28, and 42 after treatment. A total of 71 patients (22 children and 49 adults) completed the 42-day follow-up. DP remained highly efficacious for treatment of uncomplicated falciparum malaria with an overall 42-day cure rate of 100%. The day 3 parasite-positive rate was 7.04% (5/71). Within 14 days of treatment, a total of 13 (18.31%) patients had detectable gametocytes and a large proportion of these were persistent from the first three days of treatment. The presence of gametocytes in patients through 14 days after DP treatment suggests that the incorporation of a single dose of primaquine for clearing gametocytemia should be considered for blocking parasite transmission.
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Ying
Y
Wang
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Zhaoqing
Z
Yang
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Lili
L
Yuan
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Guofa
G
Zhou
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Daniel
D
Parker
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Ming-Chieh
MC
Lee
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Guiyun
G
Yan
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Qi
Q
Fan
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Yuping
Y
Xiao
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania.
Yaming
Y
Cao
Institute of Tropical Medicine, Third Military Medical University, Chongqing, China; Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China; Program in Public Health, University of California at Irvine, Irvine, California; Dalian Institute of Biotechnology, Dalian, Liaoning, China; Institute of Pathology and Pathophysiology, China Medical University, Shenyang, China; Department of Entomology, Pennsylvania State University, University Park, Pennsylvania luc2@psu.edu.
Liwang
L
Cui
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D037621:Artemisinins / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D002052:Myanmar / Q000453:epidemiology; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult; D010879:Piperazines
D000962:Antimalarials; D037621:Artemisinins; D011804:Quinolines; C039060:artenimol; C034759:piperaquine; D010879:Piperazines