Comparison of artemether-lumefantrine and chloroquine with and without primaquine for the treatment of Plasmodium vivax infection in Ethiopia: A randomized controlled trial.

PLoS Medicine
Tesfay AbrehaRic N Price

Abstract

Recent efforts in malaria control have resulted in great gains in reducing the burden of Plasmodium falciparum, but P. vivax has been more refractory. Its ability to form dormant liver stages confounds control and elimination efforts. To compare the efficacy and safety of primaquine regimens for radical cure, we undertook a randomized controlled trial in Ethiopia. Patients with normal glucose-6-phosphate dehydrogenase status with symptomatic P. vivax mono-infection were enrolled and randomly assigned to receive either chloroquine (CQ) or artemether-lumefantrine (AL), alone or in combination with 14 d of semi-supervised primaquine (PQ) (3.5 mg/kg total). A total of 398 patients (n = 104 in the CQ arm, n = 100 in the AL arm, n = 102 in the CQ+PQ arm, and n = 92 in the AL+PQ arm) were followed for 1 y, and recurrent episodes were treated with the same treatment allocated at enrolment. The primary endpoints were the risk of P. vivax recurrence at day 28 and at day 42. The risk of recurrent P. vivax infection at day 28 was 4.0% (95% CI 1.5%-10.4%) after CQ treatment and 0% (95% CI 0%-4.0%) after CQ+PQ. The corresponding risks were 12.0% (95% CI 6.8%-20.6%) following AL alone and 2.3% (95% CI 0.6%-9.0%) following AL+PQ. On day 42, th...Continue Reading

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Citations

Nov 21, 2018·The American Journal of Tropical Medicine and Hygiene·Esteban Mesa-EcheverryAlberto Tobón-Castaño
Jan 17, 2019·The New England Journal of Medicine·Marcus V G LacerdaGavin C K W Koh
Jun 4, 2019·PLoS Neglected Tropical Diseases·Lisa H VerzierJulian C Rayner
Sep 12, 2018·Antimicrobial Agents and Chemotherapy·Nilay ThakkarNavin Goyal
May 13, 2020·The American Journal of Tropical Medicine and Hygiene·Awash TeklehaimanotAdugna Woyessa
Jun 12, 2020·The American Journal of Tropical Medicine and Hygiene·Robert J CommonsRic N Price
Feb 3, 2021·International Journal for Parasitology. Drugs and Drug Resistance·Jean PopoviciDavid Serre
Dec 29, 2020·International Journal for Parasitology. Drugs and Drug Resistance·Marcelo U FerreiraJosé Pedro Gil
Feb 20, 2020·Biochemistry·Kuan-Yi Lu, Emily R Derbyshire
Mar 22, 2021·Malaria Journal·Nicholas J White
Apr 24, 2021·PLoS Medicine·Kamala ThriemerLorenz von Seidlein
May 7, 2021·International Journal for Parasitology. Drugs and Drug Resistance·Lucas E BuyonManoj T Duraisingh

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Methods Mentioned

BETA
pregnancy test
genotyping

Software Mentioned

Access
STATA

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