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A randomised controlled trial to assess the efficacy of dihydroartemisinin-piperaquine for the treatment of uncomplicated falciparum malaria in Peru

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dc.contributor.author Grande, T. en_US
dc.contributor.author Bernasconi, A. en_US
dc.contributor.author Erhart, A. en_US
dc.contributor.author Gamboa, D. en_US
dc.contributor.author Casapia, M. en_US
dc.contributor.author Delgado, C. en_US
dc.contributor.author Torres, K. en_US
dc.contributor.author Fanello, C. en_US
dc.contributor.author Llanos-Cuentas, A. en_US
dc.contributor.author D'Alessandro, U. en_US
dc.date.accessioned 2008-03-12T14:16:32Z
dc.date.available 2008-03-12T14:16:32Z
dc.date.issued 2007
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0001101
dc.identifier.other ITG-P3A en_US
dc.identifier.other ITG-PLA en_US
dc.identifier.other PARAS en_US
dc.identifier.other U-MALAR en_US
dc.identifier.other DOI en_US
dc.identifier.other ELECTRONIC en_US
dc.identifier.other FTA en_US
dc.identifier.other UPD1 en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.uri http://hdl.handle.net/10390/2165
dc.description.abstract 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%CI [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. TRIAL REGISTRATION: ClinicalTrials.gov NCT00373607. en_US
dc.language English en_US
dc.publisher Public Library of Science en_US
dc.subject Protozoal diseases en_US
dc.subject Malaria en_US
dc.subject Drug therapy en_US
dc.subject Dihydroartemisinin-piperaquine en_US
dc.subject Efficacy en_US
dc.subject Clinical trials en_US
dc.subject Peru en_US
dc.subject America, Latin en_US
dc.title A randomised controlled trial to assess the efficacy of dihydroartemisinin-piperaquine for the treatment of uncomplicated falciparum malaria in Peru en_US
dc.type Article-E en_US
dc.citation.issue 10 en_US
dc.citation.jtitle PLoS ONE en_US
dc.citation.volume 2 en_US
dc.citation.pages e1101 en_US
dc.publisher.place San Francisco en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/17971864
dc.citation.jabbreviation PLoS ONE en_US


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