In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam.

BACKGROUND: By 2009, there were worrying signs from western Cambodia that parasitological responses to artesunate-containing treatment regimens for uncomplicated Plasmodium falciparum malaria were slower than elsewhere which suggested the emergence of artemisinin resistance. Vietnam shares a long...

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Main Authors: Hien, Tran Tinh, Thuy-Nhien, Nguyen Thanh, Phu, Nguyen Hoan, Boni, Maciej F., Thanh, Ngo Viet, Nha-Ca, Nguyen Thuy, Thai, Le Hong, Thai, Cao Quang, Toi, Pham Van, Thuan, Phung Duc, Long, Le Thanh, Dong, Le Thanh, Merson, Laura, Dolecek, Christiane, Stepniewska, Kasia, Ringwald, Pascal, White, Nicholas J., Farrar, Jeremy, Wolbers, Marcel
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Language:English
Published: 2013
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/706
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spelling th-mahidol.7062023-03-30T17:56:52Z In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam. Hien, Tran Tinh Thuy-Nhien, Nguyen Thanh Phu, Nguyen Hoan Boni, Maciej F. Thanh, Ngo Viet Nha-Ca, Nguyen Thuy Thai, Le Hong Thai, Cao Quang Toi, Pham Van Thuan, Phung Duc Long, Le Thanh Dong, Le Thanh Merson, Laura Dolecek, Christiane Stepniewska, Kasia Ringwald, Pascal White, Nicholas J. Farrar, Jeremy Wolbers, Marcel Hien, Tran Tinh Mahidol University. Faculty of Tropical Medicine Artesunate Parasite clearance half-life Parasite clearance of >72 hours Parasite reduction ratio Plasmodium falciparum Open Access article BACKGROUND: By 2009, there were worrying signs from western Cambodia that parasitological responses to artesunate-containing treatment regimens for uncomplicated Plasmodium falciparum malaria were slower than elsewhere which suggested the emergence of artemisinin resistance. Vietnam shares a long land border with Cambodia with a large number of migrants crossing it on a daily basis. Therefore, there is an urgent need to investigate whether there is any evidence of a change in the parasitological response to the artemisinin derivatives in Vietnam. METHODS: From August 2010 to May 2011, a randomized controlled clinical trial in uncomplicated falciparum malaria was conducted to compare two doses of artesunate (AS) (2mg/kg/day versus 4 mg/kg/day for three days) followed by dihydroartemisinin-piperaquine (DHA-PPQ) and a control arm of DHA-PPQ. The goal was characterization of the current efficacy of artesunate in southern Vietnam. The primary endpoint of this study was the parasite clearance half-life; secondary endpoints included the parasite reduction ratios at 24 and 48 hours and the parasite clearance time. RESULTS: 166 patients were recruited into the study. The median parasite clearance half-lives were 3.54 (AS 2mg/kg), 2.72 (AS 4mg/kg), and 2.98 hours (DHA-PPQ) (p=0.19). The median parasite-reduction ratio at 24 hours was 48 in the AS 2mg/kg group compared with 212 and 113 in the other two groups, respectively (p=0.02). The proportions of patients with a parasite clearance time of >72 hours for AS 2mg/kg, AS 4mg/kg and DHA-PPQ were 27%, 27%, and 22%, respectively. Early treatment failure occurred in two (4%) and late clinical failure occurred in one (2%) of the 55 patients in the AS 2mg/kg group, as compared with none in the other two study arms. The PCR-corrected adequate clinical and parasitological response (APCR) rates in the three groups were 94%, 100%, and 100% (p=0.04). CONCLUSIONS: This study demonstrated faster P. falciparum parasite clearance in southern Vietnam than in western Cambodia but slower clearance in comparison with historical data from Vietnam. Further studies to determine whether this represents the emergence of artemisinin resistance in this area are needed. Currently, the therapeutic response to DHA-PPQ remains satisfactory in southern Vietnam. 2013-01-03T01:46:34Z 2016-09-22T05:59:40Z 2013-01-03T01:46:34Z 2016-09-22T05:59:40Z 2012 2013-01-03 2012-10-26 Research Article Hien TT, Thuy-Nhien NT, Phu NH, Boni MF, Thanh NV, Nha-Ca NT, et al. In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam. Malar J. 2012 Oct 26;11:355. 10.1186/1475-2875-11-355 1475-2875 (electronic) https://repository.li.mahidol.ac.th/handle/123456789/706 eng Mahidol University BioMed Central application/pdf
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
language English
topic Artesunate
Parasite clearance half-life
Parasite clearance of >72 hours
Parasite reduction ratio
Plasmodium falciparum
Open Access article
spellingShingle Artesunate
Parasite clearance half-life
Parasite clearance of >72 hours
Parasite reduction ratio
Plasmodium falciparum
Open Access article
Hien, Tran Tinh
Thuy-Nhien, Nguyen Thanh
Phu, Nguyen Hoan
Boni, Maciej F.
Thanh, Ngo Viet
Nha-Ca, Nguyen Thuy
Thai, Le Hong
Thai, Cao Quang
Toi, Pham Van
Thuan, Phung Duc
Long, Le Thanh
Dong, Le Thanh
Merson, Laura
Dolecek, Christiane
Stepniewska, Kasia
Ringwald, Pascal
White, Nicholas J.
Farrar, Jeremy
Wolbers, Marcel
In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam.
description BACKGROUND: By 2009, there were worrying signs from western Cambodia that parasitological responses to artesunate-containing treatment regimens for uncomplicated Plasmodium falciparum malaria were slower than elsewhere which suggested the emergence of artemisinin resistance. Vietnam shares a long land border with Cambodia with a large number of migrants crossing it on a daily basis. Therefore, there is an urgent need to investigate whether there is any evidence of a change in the parasitological response to the artemisinin derivatives in Vietnam. METHODS: From August 2010 to May 2011, a randomized controlled clinical trial in uncomplicated falciparum malaria was conducted to compare two doses of artesunate (AS) (2mg/kg/day versus 4 mg/kg/day for three days) followed by dihydroartemisinin-piperaquine (DHA-PPQ) and a control arm of DHA-PPQ. The goal was characterization of the current efficacy of artesunate in southern Vietnam. The primary endpoint of this study was the parasite clearance half-life; secondary endpoints included the parasite reduction ratios at 24 and 48 hours and the parasite clearance time. RESULTS: 166 patients were recruited into the study. The median parasite clearance half-lives were 3.54 (AS 2mg/kg), 2.72 (AS 4mg/kg), and 2.98 hours (DHA-PPQ) (p=0.19). The median parasite-reduction ratio at 24 hours was 48 in the AS 2mg/kg group compared with 212 and 113 in the other two groups, respectively (p=0.02). The proportions of patients with a parasite clearance time of >72 hours for AS 2mg/kg, AS 4mg/kg and DHA-PPQ were 27%, 27%, and 22%, respectively. Early treatment failure occurred in two (4%) and late clinical failure occurred in one (2%) of the 55 patients in the AS 2mg/kg group, as compared with none in the other two study arms. The PCR-corrected adequate clinical and parasitological response (APCR) rates in the three groups were 94%, 100%, and 100% (p=0.04). CONCLUSIONS: This study demonstrated faster P. falciparum parasite clearance in southern Vietnam than in western Cambodia but slower clearance in comparison with historical data from Vietnam. Further studies to determine whether this represents the emergence of artemisinin resistance in this area are needed. Currently, the therapeutic response to DHA-PPQ remains satisfactory in southern Vietnam.
author2 Hien, Tran Tinh
author_facet Hien, Tran Tinh
Hien, Tran Tinh
Thuy-Nhien, Nguyen Thanh
Phu, Nguyen Hoan
Boni, Maciej F.
Thanh, Ngo Viet
Nha-Ca, Nguyen Thuy
Thai, Le Hong
Thai, Cao Quang
Toi, Pham Van
Thuan, Phung Duc
Long, Le Thanh
Dong, Le Thanh
Merson, Laura
Dolecek, Christiane
Stepniewska, Kasia
Ringwald, Pascal
White, Nicholas J.
Farrar, Jeremy
Wolbers, Marcel
format Article
author Hien, Tran Tinh
Thuy-Nhien, Nguyen Thanh
Phu, Nguyen Hoan
Boni, Maciej F.
Thanh, Ngo Viet
Nha-Ca, Nguyen Thuy
Thai, Le Hong
Thai, Cao Quang
Toi, Pham Van
Thuan, Phung Duc
Long, Le Thanh
Dong, Le Thanh
Merson, Laura
Dolecek, Christiane
Stepniewska, Kasia
Ringwald, Pascal
White, Nicholas J.
Farrar, Jeremy
Wolbers, Marcel
author_sort Hien, Tran Tinh
title In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam.
title_short In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam.
title_full In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam.
title_fullStr In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam.
title_full_unstemmed In vivo susceptibility of Plasmodium falciparum to artesunate in Binh Phuoc Province, Vietnam.
title_sort in vivo susceptibility of plasmodium falciparum to artesunate in binh phuoc province, vietnam.
publishDate 2013
url https://repository.li.mahidol.ac.th/handle/123456789/706
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