title: A Randomized Comparison of Chloroquine Versus Dihydroartemisinin-Piperaquine for the Treatment of Plasmodium vivax Infection in Vietnam.
abstract: A total of 128 Vietnamese patients with symptomatic Plasmodium vivax mono-infections were enrolled in a prospective, open-label, randomized trial to receive either chloroquine or dihydroartemisinin-piperaquine (DHA-PPQ). The proportions of patients with adequate clinical and parasitological responses were 47% in the chloroquine arm (31 of 65 patients) and 66% in the DHA-PPQ arm (42 of 63 patients) in the Kaplan-Meier intention-to-treat analysis (absolute difference 19%, 95% confidence interval = 0-37%), thus establishing non-inferiority of DHA-PPQ. Fever clearance time (median 24 versus 12 hours,P= 0.02), parasite clearance time (median 36 versus 18 hours,P< 0.001), and parasite clearance half-life (mean 3.98 versus 1.80 hours,P< 0.001) were all significantly shorter in the DHA-PPQ arm. All cases of recurrent parasitemia in the chloroquine arm occurred from day 33 onward, with corresponding whole blood chloroquine concentration lower than 100 ng/mL in all patients. Chloroquine thus remains efficacious for the treatment of P. vivax malaria in southern Vietnam, but DHA-PPQ provides more rapid symptomatic and parasitological recovery.
authors: Phung Duc
authors: PD
authors: Thuan
authors: Nguyen Thuy Nha
authors: NTN
authors: Ca
authors: Pham
authors: P
authors: Van Toi
authors: Nguyen Thanh Thuy
authors: NTT
authors: Nhien
authors: Ngo Viet
authors: NV
authors: Thanh
authors: Nguyen Duc
authors: ND
authors: Anh
authors: Nguyen Hoan
authors: NH
authors: Phu
authors: Cao Quang
authors: CQ
authors: Thai
authors: Le Hong
authors: LH
authors: Thai
authors: Nhu Thi
authors: NT
authors: Hoa
authors: Le Thanh
authors: LT
authors: Dong
authors: Mai Anh
authors: MA
authors: Loi
authors: Do Hung
authors: DH
authors: Son
authors: Tran Tinh Ngoc
authors: TTN
authors: Khanh
authors: Christiane
authors: C
authors: Dolecek
authors: Ho Thi
authors: HT
authors: Nhan
authors: Marcel
authors: M
authors: Wolbers
authors: Guy
authors: G
authors: Thwaites
authors: Jeremy
authors: J
authors: Farrar
authors: Nicholas J
authors: NJ
authors: White
authors: Tran Tinh
authors: TT
authors: Hien
mesh_terms: D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D037621:Artemisinins / Q000008:administration & dosage / Q000627:therapeutic use*; D002738:Chloroquine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016780:Malaria, Vivax / Q000188:drug therapy*; D008297:Male; D010966:Plasmodium vivax / Q000187:drug effects*; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014744:Vietnam; D055815:Young Adult; D010879:Piperazines
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D002738:Chloroquine; D011804:Quinolines; C039060:artenimol; C034759:piperaquine; D010879:Piperazines