Plasmodium vivax remains the predominant malaria parasite in China, particularly in regions like Yunnan Province, which experiences both vivax and falciparum malaria transmission. As part of national efforts to eliminate malaria by 2020, effective treatment strategies are crucial, especially for radical cure of P. vivax infections. This open-label randomized non-inferiority trial evaluated the efficacy and safety of artemisinin-naphthoquine (ANQ) compared to the standard chloroquine-primaquine (CQ-PQ) regimen in treating uncomplicated P. vivax monoinfections among patients in Yunnan Province.
A total of 260 eligible patients aged over five years with parasite densities ranging from 400 to 100,000 per microliter were enrolled between February 2009 and December 2010 at Tengchong County Center for Disease Control and Prevention and local hospitals along the China-Myanmar border.Isatuximab (anti-CD38) custom synthesis Participants were randomly assigned to receive either ANQ (naphthoquine 7 mg/kg + artemisinin 17.5 mg/kg) once daily for three days or CQ (24 mg base/kg/day) for three days plus primaquine (0.45 mg base/kg/day) for eight days. All patients were followed up for one year through monthly visits, including blood smear examinations and symptom monitoring.Rosmarinic acid manufacturer
Primary endpoints included the proportion of patients free of recurrence by day 42, while secondary endpoints included recurrence rates at day 28 and day 365, parasite and fever clearance times, and adverse events.PMID:35155577 By day 42, 125 patients (98.4%; 95% CI, 94.4–99.8%) in the ANQ group and 123 (96.1%; 95% CI, 91.1–98.7%) in the CQ-PQ group remained free of recurrence, with no statistically significant difference (P = 0.4496). At day 365, 101 patients (79.5%; 95% CI, 71.8–85.9%) in the ANQ group and 106 (82.8%; 95% CI, 75.1–88.9%) in the CQ-PQ group had no recurrence (P = 0.610), indicating comparable long-term efficacy.
Parasite clearance occurred rapidly in both groups, with all patients clearing parasitemia by day 3. ANQ demonstrated faster parasite and gametocyte clearance times compared to CQ-PQ (P < 0.0001). Fever clearance time was also significantly shorter in the ANQ group (mean 26.7 vs. 36.2 hours; P < 0.0001). Adverse events were reported in 49 patients (19.2%), with no significant difference between groups (RR 1.05; 95% CI, 0.63–1.74; P = 0.97). Nausea and anorexia were the most common side effects, occurring in 7.1% and 7.1% of the ANQ group versus 5.5% and 5.5% in the CQ-PQ group. Notably, two patients in the CQ-PQ arm withdrew due to severe hemoglobinuria after primaquine administration, suggesting potential G6PD deficiency, which is prevalent in this region (estimated 2.3%). The results demonstrate that a three-day ANQ regimen is non-inferior to the eight-day CQ-PQ regimen in preventing P. vivax recurrence, with superior tolerability and faster clinical response. Given its short course, high adherence, and favorable safety profile, ANQ presents a promising alternative for P. vivax treatment in endemic areas where primaquine use is limited by toxicity concerns. The study supports the integration of artemisinin-based combination therapies into routine management of vivax malaria, especially in co-endemic settings.MedChemExpress (MCE) offers a wide range of high-quality research chemicals and biochemicals (novel life-science reagents, reference compounds and natural compounds) for scientific use. We have professionally experienced and friendly staff to meet your needs. We are a competent and trustworthy partner for your research and scientific projects.Related websites: https://www.medchemexpress.com