Reduced efficacy of pyronaridine-artesunate (Pyramax®) for the treatment of uncomplicated plasmodium falciparum malaria in children in Gia Lai Province, Vietnam (2022-2023)
Nội dung chính của bài viết
Tóm tắt
There are limited data on the tolerability and efficacy of pyronaridine-artesunate (Pyramax®) for the first-line treatment of Plasmodium falciparum malaria in children. A three-day course of Pyramax® plus one dose of primaquine was administered to 50 children and 70 adults (mean age of 13.8 and 31.6 years old, respectively) infected with P. falciparum in Krong Pa district, Gia Lai province in 2022 and 2023. The follow-up period was 42 days after commencement of treatment. Pyramax® was well-tolerated, with no serious adverse event reported. The PCR-adjusted adequate clinical and parasitological response at Day 42 in children was lower than in adults (86.7%, 39/45 vs 96.7%, 59/61; P=0.069). 44.9% (22/49) children and 54.3% (38/70) adults were detected with asexual parasites on Day 3, suggestive of partial artemisinin resistance. The six children, who experienced recrudescent malaria, had significantly higher median parasitemia on Day 0 (27,693 parasites/µL vs 13,395 parasites/µL; P=0.047) and lower median blood pyronaridine concentrations on Day 7 (33.0 ng/mL vs 49.2 ng/mL; P=0.106) compared to those who remained malaria-free by Day 42. The lower efficacy of Pyramax® in children is concerning and requires monitoring.
Chi tiết bài viết
Từ khóa
Pyronaridine-artesunate, Pyramax®, Plasmodium falciparum, children, Gia Lai, Viet Nam
Tài liệu tham khảo
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