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Clinical Trial
. 2015 Sep;93(3):577-83.
doi: 10.4269/ajtmh.15-0029. Epub 2015 Aug 17.

Clinical Efficacy of Dihydroartemisinin-Piperaquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria at the China-Myanmar Border

Ying Wang  1 , Zhaoqing Yang  1 , Lili Yuan  1 , Guofa Zhou  1 , Daniel Parker  1 , Ming-Chieh Lee  1 , Guiyun Yan  1 , Qi Fan  1 , Yuping Xiao  1 , Yaming Cao  1 , Liwang Cui  2
Affiliations
Clinical Trial

Clinical Efficacy of Dihydroartemisinin-Piperaquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria at the China-Myanmar Border

Ying Wang et al. Am J Trop Med Hyg. 2015 Sep.

Abstract

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.

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Figures

Figure 1.
Figure 1.
Map of the study sites.
Figure 2.
Figure 2.
Flow chart of the dihydroartemisinin–piperaquine (DP) efficacy study of Plasmodium falciparum patients during 2012–2013.
Figure 3.
Figure 3.
Mean Plasmodium falciparum asexual parasite density (per microliter) of P. falciparum patients during the first 3 days after dihydroartemisinin–piperaquine (DP) treatment.
Figure 4.
Figure 4.
Kaplan–Meier's survival analysis of the clearance of asexual parasites (A) and gametocytes (B) of the children (≤ 15 years) and adult (> 15 years).
See this image and copyright information in PMC

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