Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/83425
Full metadata record
DC FieldValueLanguage
dc.contributor.authorGrigg, Matthew J.en
dc.contributor.authorWilliam, Timothyen
dc.contributor.authorMenon, Jayaramen
dc.contributor.authorBarber, Bridget E.en
dc.contributor.authorWilkes, Christopher S.en
dc.contributor.authorRajahram, Giri S.en
dc.contributor.authorEdstein, Michael D.en
dc.contributor.authorAuburn, Sarahen
dc.contributor.authorPrice, Ric N.en
dc.contributor.authorYeo, Tsin W.en
dc.contributor.authorYeo, Tsin Wenen
dc.contributor.authorAnstey, Nicholas M.en
dc.date.accessioned2016-09-06T04:24:09Zen
dc.date.accessioned2019-12-06T15:22:17Z-
dc.date.available2016-09-06T04:24:09Zen
dc.date.available2019-12-06T15:22:17Z-
dc.date.issued2016en
dc.identifier.citationGrigg, M. J., William, T., Menon, J., Barber, B. E., Wilkes, C. S., Rajahram, G. S., et al. (2016). Efficacy of Artesunate-mefloquine for Chloroquine-resistant Plasmodium vivax Malaria in Malaysia: An Open-label, Randomized, Controlled Trial. Clinical Infectious Diseases, 62(11), 1403-1411.en
dc.identifier.issn1058-4838en
dc.identifier.urihttps://hdl.handle.net/10356/83425-
dc.description.abstractBackground: Chloroquine (CQ)-resistant Plasmodium vivax is increasingly reported throughout southeast Asia. The efficacy of CQ and alternative artemisinin combination therapies (ACTs) for vivax malaria in Malaysia is unknown. Methods: A randomized, controlled trial of CQ vs artesunate-mefloquine (AS-MQ) for uncomplicated vivax malaria was conducted in 3 district hospitals in Sabah, Malaysia. Primaquine was administered on day 28. The primary outcome was the cumulative risk of treatment failure by day 28 by Kaplan–Meier analysis. Results: From 2012 to 2014, 103 adults and children were enrolled. Treatment failure by day 28 was 61.1% (95% confidence interval [CI], 46.8–75.6) after CQ and 0% (95% CI, 0–.08) following AS-MQ (P < .001), of which 8.2% (95% CI, 2.5–9.6) were early treatment failures. All patients with treatment failure had therapeutic plasma CQ concentrations at day 7. Compared with CQ, AS-MQ was associated with faster parasite clearance (normalized clearance slope, 0.311 vs 0.127; P < .001) and fever clearance (mean, 19.0 vs 37.7 hours; P = .001) and with lower risk of anemia at day 28 (odds ratio = 3.7; 95% CI, 1.5–9.3; P = .005). Gametocytes were present at day 28 in 23.8% (10/42) of patients following CQ vs none with AS-MQ (P < .001). AS-MQ resulted in lower bed occupancy: 4037 vs 6510 days/1000 patients (incidence rate ratio 0.62; 95% CI, .60–.65; P < .001). One patient developed severe anemia not regarded as related to their AS-MQ treatment. Conclusions: High-grade CQ-resistant P. vivax is prevalent in eastern Malaysia. AS-MQ is an efficacious ACT for all malaria species. Wider CQ-efficacy surveillance is needed in vivax-endemic regions with earlier replacement with ACT when treatment failure is detected.en
dc.format.extent9 p.en
dc.language.isoenen
dc.relation.ispartofseriesClinical Infectious Diseasesen
dc.rights© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.en
dc.subjectPlasmodium vivaxen
dc.subjectMalariaen
dc.titleEfficacy of Artesunate-mefloquine for Chloroquine-resistant Plasmodium vivax Malaria in Malaysia: An Open-label, Randomized, Controlled Trialen
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en
dc.identifier.doi10.1093/cid/ciw121en
dc.description.versionPublished versionen
dc.identifier.pmid27107287-
item.fulltextWith Fulltext-
item.grantfulltextopen-
Appears in Collections:LKCMedicine Journal Articles

SCOPUSTM   
Citations 10

38
Updated on Mar 24, 2024

Web of ScienceTM
Citations 10

36
Updated on Oct 31, 2023

Page view(s) 50

461
Updated on Mar 28, 2024

Download(s) 50

152
Updated on Mar 28, 2024

Google ScholarTM

Check

Altmetric


Plumx

Items in DR-NTU are protected by copyright, with all rights reserved, unless otherwise indicated.