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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
A randomised controlled trial to assess the efficacy of dihydroartemisinin-piperaquine for the treatment of uncomplicated falciparum malaria in Peru
PLoS ONE, Volume 2, No. 10, Article e1101, Year 2007
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Description
Background. Multi-drug resistant falciparum malaria is an important health problem in the Peruvian Amazon region. We carried out a randomised open label clinical trial comparing mefloquine-artesunate, the current first line treatment in this region, with dihydroartemisinin-piperaquine. Methods and Findings. Between July 2003 and July 2005, 522 patients with P. falciparum uncomplicated malaria were recruited, randomized (260 with mefloquine-artesunate and 262 with dihydroartemisinin-piperaquine), treated and followed up for 63 days. PCR-adjusted adequate clinical and parasitological response, estimated by Kaplan Meier survival and Per Protocol analysis, was extremely high for both drugs (99.6% for mefloquine-artesunate and 98.4% and for dihydroartemisinin-piperaquine) (RR: 0.99, 95%CI [0.97-1.01], Fisher Exact p=0.21). All recrudescences were late parasitological failures. Overall, gametocytes were cleared faster in the mefloquine-artesunate group (28 vs 35 days) and new gametocytes tended to appear more frequently in patients treated with dihydroartemisinin-piperaquine (day 7: 8 (3.6%) vs 2 (0.9%), RR: 3.84, 95%Cl [0.82-17.87]). Adverse events such as anxiety and insomnia were significantly more frequent in the mefloquine-artesunate group, both in adults and children. Conclusion. Dihydroartemisinin-piperaquine is as effective as mefloquine-artesunate in treating uncomplicated P. falciparum malaria but it is better tolerated and more affordable than mefloquine-artesunate (US$1.0 versus US$18.65 on the local market). Therefore, it should be considered as a potential candidate for the first line treatment of P.falciparum malaria in Peru. © 2007 Grande et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2040506/bin/pone.0001101.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2040506/bin/pone.0001101.s002.doc
Authors & Co-Authors
Erhart, Annette
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Gamboa Vilela, Dionicia V.
Peru, Lima
Universidad Peruana Cayetano Heredia
Casapia, Martin
Peru, Lima
Ministerio de Salud, Lima
Delgado-Ratto, Christopher
Peru, Lima
Universidad Peruana Cayetano Heredia
Torres, Katherine J.
Peru, Lima
Universidad Peruana Cayetano Heredia
Fanello, Caterina I.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Llanos-Cuentas, E. Alejandro
Peru, Lima
Universidad Peruana Cayetano Heredia
D'Alessandro, Umberto
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Statistics
Citations: 43
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0001101
ISSN:
19326203
Research Areas
Infectious Diseases
Maternal And Child Health
Mental Health
Study Design
Randomised Control Trial