Artemisinin or chloroquine for blood stage Plasmodium vivax malaria in Vietnam
Artemisinin or chloroquine for blood stage Plasmodium vivax malaria in Vietnam
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DOI：
10.1046/j.1365-3156.2002.00948.x
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发表时间：
2002-10-01
影响因子：
3.3
通讯作者：
Kager, PA
中科院分区：
文献类型：
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作者：
Phan, GT;de Vries, PJ;Kager, PA
在越南尚未出现抗氯喹间日疟原虫。青蒿素对间日疟原虫的疗效尚未确定。我们进行了一项双盲随机研究，涉及240名间日疟原虫疟疾住院患者，他们接受青蒿素（40 mg/kg，3天）+安慰剂氯喹（Art）或氯喹（25 mg/kg，3天）+安慰剂青蒿素（Chl）。患者每周进行一次血液涂片随访，持续28天。每组113例进行了分析。所有患者均迅速恢复。Art方案的中位（范围）寄生虫清除时间为24 h（8-72），Chl方案为24 h（8-64; P = 0.3）。第14天每组中有2例再次出现寄生虫，第16天每组中有8例（7%）再次出现寄生虫，4周随访结束时分别有25例（23%）和18例（16%）再次出现寄生虫（P = 0.3）。种群寄生虫清除曲线呈单指数下降。两种方案每48小时生殖周期的寄生虫减少率均为2.3 × 10（4）。我们的结论是，青蒿素和氯喹是同样有效的治疗间日疟原虫感染在越南。在第16天之前寄生虫的再现（7%）表明氯喹抗性的出现。三天的青蒿素单药疗法并不能防止复发。
Chloroquine-resistant Plasmodium vivax has not yet occurred in Vietnam. The efficacy of artemisinin for P. vivax was not established. We conducted a double-blind randomized study involving 240 inpatients with P. vivax malaria who received artemisinin (40 mg/kg over 3 days) plus placebo chloroquine (Art) or chloroquine (25 mg/kg over 3 days) plus placebo artemisinin (Chl). Patients were followed up with weekly blood smears for 28 days. In each group 113 cases were analysed. All patients recovered rapidly. The median (range) parasite clearance time of regimen Art was 24 h (8-72) and of Chl 24 h (8-64; P = 0.3). Parasites reappeared in two cases in each group on day 14, in eight cases in each group (7%) on day 16 and in 25 (23%) and 18 (16%) cases, respectively, at the end of 4-week follow-up (P = 0.3). The population parasite clearance curve followed a mono-exponential decline. The parasite reduction ratio per 48 h reproduction cycle was 2.3 x 10(4) for both regimens. We conclude that artemisinin and chloroquine are equally effective in the treatment of P. vivax infections in Vietnam. Reappearance of parasites before day 16 (7%) suggests the emergence of chloroquine resistance. Three days of artemisinin monotherapy does not prevent recrudescence.