No evidence for spread of Plasmodium falciparum artemisinin resistance to Savannakhet Province, Southern Laos.

Abstract

We conducted an open-label, randomized clinical trial to assess parasite clearance times (PCT) and the efficacy of 4 mg/kg (group 1, n = 22) and 2 mg/kg (group 2, n = 22) of oral artesunate for three days followed by artemether-lumefantrine in patients with uncomplicated Plasmodium falciparum malaria at Xepon Interdistrict Hospital, Savannakhet Province in southern Laos. Slides were read in duplicate. The overall mean (95% confidence interval; range) PCT in hours was 23.2 (21.2-25.3; 12-46) and 22.4 (20.3-24.5; 12-46) for the first and second microscopists, respectively (P = 0.57). Ten (23%) patients remained parasitemic on day 1 after treatment (4 [18%] in group 1 and 6 [27%] in group 2; P = 0.47). No patient had patent asexual parasitemia on the second and third days of treatment. The 42-day polymerase chain reaction-corrected cure rates were 100% in both treatment groups. Serious adverse events did not develop during or after treatment in any patients. In conclusion, no evidence of P. falciparum in vivo resistance to artesunate was found in southern Laos.

• Authors: Mayfong Mayxay, Maniphone Khanthavong, Odai Chanthongthip, Mallika Imwong, Sue J Lee, Kasia Stepniewska, Bongkot Soonthornsata, Tiengkham Pongvongsa, Samlane Phompida, Bouasy Hongvanthong, Pascal Ringwald, Nicholas J White, Paul N Newton
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 86 Issue 3 Pg. 403-408 (Mar 2012) ISSN: 1476-1645 [Electronic] United States
• PMID: 22403308 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antimalarials
• Artemether, Lumefantrine Drug Combination
• Artemisinins
• Drug Combinations
• Ethanolamines
• Fluorenes
• Artesunate
• artemisinin

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Antimalarials (therapeutic use)
• Artemether, Lumefantrine Drug Combination
• Artemisinins (therapeutic use)
• Artesunate
• Child
• Drug Combinations
• Drug Resistance
• Drug Therapy, Combination
• Ethanolamines
• Female
• Fluorenes (therapeutic use)
• Follow-Up Studies
• Humans
• Laos (epidemiology)
• Malaria, Falciparum (drug therapy, parasitology)
• Male
• Middle Aged
• Plasmodium falciparum (drug effects, pathogenicity)
• Treatment Outcome
• Young Adult