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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Malaria Journal 1/2012

Therapeutic efficacy of artemether-lumefantrine for Plasmodium vivax infections in a prospective study in Guyana

Zeitschrift:
Malaria Journal > Ausgabe 1/2012
Autoren:
Daniel Eibach, Nicolas Ceron, Karanchand Krishnalall, Keith Carter, Guillaume Bonnot, Anne-Lise Bienvenu, Stéphane Picot
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2875-11-347) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

DE contributed to molecular genetic studies, interpretation of results and the drafting of the manuscript. NC organized the collection of samples in Guyana and helped with the interpretation of results. KK and KC contributed to the study design and the interpretation of results. GB generated a portion of the molecular data. ALB contributed to the interpretation of the data and writing of the manuscript. SP contributed to the study design, interpretation of results and the writing of the manuscript. All authors read and approved the final manuscript.

Abstract

Background

In Guyana, chloroquine + primaquine is used for the treatment of vivax malaria. A worldwide increase of chloroquine resistance in Plasmodium vivax led to questioning of the current malaria treatment guidelines. A therapeutic efficacy study was conducted using artemether-lumefantrine + primaquine against P. vivax to evaluate a treatment alternative for chloroquine.

Methods

From 2009 to 2010, a non-controlled study in two hospitals in Guyana was conducted. A total 61 patients with P. vivax infection were treated with artemether-lumefantrine as a six-dose regimen twice a day for three days with additional 0.25 mg/kg/d primaquine at day 0 for 14 days. Clinical and parasitological parameters were followed on days 0,1,2,3,7,14 and 28 in agreement with WHO guidelines. Plasmodium vivax DNA from eight patients was analysed for pvmdr1, molecular marker of resistance.

Results

Artemether-lumefantrine cleared 100% of parasites on day 1, but two patients (3%) had recurrence of parasites on day 28, suggesting relapse. No pvmdr1 Y976F polymorphism was detected. The treatment regimen was well tolerated.

Conclusions

In Guyana, artemether-lumefantrine represents an adequate treatment option against P. vivax when combined with primaquine. Availability of this alternative will be of great importance in case of emerging chloroquine resistance against P. vivax.
Zusatzmaterial
Authors’ original file for figure 1
12936_2012_2453_MOESM1_ESM.pdf
Literatur
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