Pre-clinical & clinical trials of Arterakin (dihydroartemisinin-piperaquine) in treatment of uncomplicated malaria in Vietnam

A high therapeutic efficacy was found in the experimental mouse model infected with P. berghei (both chloroquin sensitive and resistant strains). At a low dose, as twice as the human dose and calculated as mg/kg of body weight of mice, the combination produced a high effect, clearing parasite within 3 days. However a considerable rate of recrudescence (10%) was found within 28 following-up days. At a high dose as tenth as a human dose, the combination was found to have a high therapeutic effect of 100% cure rate on mice clearing parasite within 2 days and no recurrence occured within 28 following-up days in all the tests. Arterakin was found to be a highly effective antimalaria drug with cure rate of 100% and a fast parasite clearance time (1-2 days) in both P falciparum and P. vivax infected patients. The total dose of 8 tablets for 3 days for adults and relevant doses for children appeared to be appropriate

Acute toxicity of trifluoropropyloxydihydroartemisinin (BB101) in monkey

Acute toxicity of injectable doses of 40mg/kg, 80mg/kg, 120mg/kg, 160mg/kg of BB101 (trifluoromethyl hydroartemisinine) corresponding to 1/10,1/5, 1/4, 1/3 of LD50 by injection on monkey was studied. With the doses of 40mg/kg and 80mg/kg, on monkey, normal living activity was still manifested except anorexia, weight loss, hair fall...Bad conditions had been aggravating with the increasing doses. At the dose of 120mg/kg, monkey died 2 days after interruption of toxic substance and at the dose of 160mg/kg, monkey died on the day N5.As regards biochemistry indices, BB101 in 5 consecutive days with the daily dose of 40mg/kg and 80mg/kg enhanced SGOT, SGPT, proteine and creatinine (in permitted intervals);with 120mg/kg and 160mg/kg enhanced SGOT and SGPT by 3-5 folds higher, other indices were in permissible intervals. As regards hematological indices; white blood count, red blood count and haemoglobine reduced

Sensitivity and specificity asan easy malaria P.f/P.v tests for diagnosis of P. falciparum and P. vivax in Vietnam

Sensitivity and specificity of the Asan Easy Malaria P.f/P.v tests (made by Asan Korean Company) in the diagnosis of P. falciparum and P.vivax malaria was investigated compared to Giemsa microscopy and re-checked by PCR technique. A total of 283 tests were conducted in the provinces of Lai Chau, Quang Binh and Binh Phuoc, and 90 other ones were carried out with cultured P. falciparum at the laboratories of the National Institute of Malariology, Parasitology and Entomology. The different results were found with two method as 111 positive cases were confirmed by Giemsa staining (59 P.falciparum and 54 P.vivax), while only 94 positive tests (53 P.falciparum and P.vivax) were determined by Asan. The samples with different results by two methods were re-cheked by PCR technique for confimation. The sensitivity and specificity of Asan tests in Plasmodium species detection were 97.8 and 89.9%, respectively, in general, and 99.0% and 91.2% in diagnosis of P falciparum, and 75.9% and 97% of P. vivax, in particular. However, in the following-up period (2-3 days), both methods showed the same results of parasite re-examination

Therapeutic efficacy of dihydroartemisinin-piperaquin combination in malaria treatment in Vietnam

Therapeutic efficacy of dihydroartemisinin (DHA) - piperaquin in treatment of P falciparum and P. vivax was investigated in the National Institute of Malariology, Parasitology and Entomology (NIMPE), Hospital of Tropical Diseases in Ho Chi Minh city. Hospital inpatients and patients in primary health care facilities were enrolled in the study. Four small scale clinical studies were conducted and followed by large scale treatment studies in the Hospital of Tropical Diseases and primary health care services in the provinces of Binh Phuoc, Dak Lak, Quang Tri during the period 2001 - 2004. A total number of 3,978 malaria patients (989 P. vivax and 2,999 P falciparum were sampled

Timothy M.E. Davis, Janet Cox - Singh, Sean Hewitt. Treatment of uncomplicated falciparum malaria in Southern Vietnam: can chloroquine or sulfadoxine - pyrimethamine be introduced in combination with artesunate

The efficacy of chloroquine or sulfadoxine-pyrimethamine given combined with artesunate was assessed in Vietnamese patients with uncomplicated falciparum malaria from 2 Southern provinces, where there was in vitro evidence that the sensitivity of the parasite to conventional antimalarial therapies had returned in the absence of drug pressure, from October to December of 2000. In Dak Lak province, 57 patients (mean age 9.6 years) were randomized to artesunate-chloroquine (group 1) or artesunate-sulfadoxine/pyrimethamine (group 2). In Binh Phuoc province, 66 patients, who have just migrated in period of 1-7 years (mean age 24.2 years) were assessed with the 2 regimens. The results of 28 days in vivo response were over 96% and lower 52% of Dak Lak and Binh Phuoc respectively. PCR evidence of cure closely paralleled the in vivo results. The successful reintroduction of chloroquine and sulfadoxine-pyrimethamine as artemisinin partner drugs depends heavily on epidemiological and parasite factors

Detection of P.falciparum and P.vivax sporozoites in mosquitoes by ELISA

A total of 10.140 Anopheles mosquitoes were collected during the period 1985-1995 in 5 study sites. ELISA(+) reactions were detected in 229 mosquito samples from 10 Anopheles species of An.minimus, An.dirus, An.vagns, An.maculatus, An.subpictus, An.campestris, An.tessellatus, An.jeyporiensis, An.aconitus, An.spl. In Bai Tranh (Thanh Hoa province), Khanh Phu and Khanh Nam (Khanh Hoa province), 7 species were found to be infected with malaria sporozoites as An.minimus, An.dirus, An.vagus, An.maculatus. An.aconitus, An.tessellatus, An.jeyporiensis. In the brackish water commune Phong Phu (Binh Chanh district, HCM city) and in Can Giuoc district (Long An province), 7 species were found to be infected with malaria sporozoites as An. subpictus, An.sinensis, An.sundaicus, An.campestris, An.vagus, An.tessellatuss, An.spl. The positive infection rate was An.dirus (4,5% - 8,5%), An.minimus (8,3%) in Khanh Phu and Khanh Nam (Khánh Hòa) and An.sinensis (4,5% - 11%). An.campestris (6,6% - 6,7%), An.vagus (4,6%) in Phong Phu (HCM city) and Can Giuoc (Long An)

Clinical trial of CV. artecan (dihydroartemisinin-piperaquine) combination against malaria in Viet nam

The evaluation of the safety and therapeuctic efficacy of CV.artecan (dihydroartemisinin 40mg - piperaquine 320mg) combination in experimental mice. LD50 dose of CV.artecan were identified in experimental mice. In vitro test was carried out on mice injected P.berghei (chloroquine resistant isolate) treated with various doses of CV.artecan: 115.2mg/kg; 230.4mg/kg; 460.8mg/kg and 921.6mg/kg. In vivo tests of CV.artecan with the total doses of 6.2/51.2mg/kg in 137 patients with uncomplicated malaria.Therapeutic dose of adults in the first day: 4 tablets divided into 2 times, the first day and second day: 2 tablets per day, the children doses acorrding to age. The patients were followed up for 28 days. The results: The dose LD50 of CV.artecan was identified as 2167mg/kg (2129-2205mg/kg). The total dose of CV.artecan 57mg/kg in malaria patients was far duration from LD50 doses

G6PD deficiency in some ethnic groups living in the malaria endemic areas

A survey had been carried out on 2.254 persons (including male and female) of 5 districts in the malaria hyper-endemic areas of Khanh Hoa, Gia Lai and Binh Phuoc provinces from 1999 to 2000. The results showd that, the G6PD deficiency prevalence varied in different ethnic groups: it was 17.1% in the Tay, and 11.1% in the Nung and Dao groups. These groups were migrating from North provinces. The other local ethnic groups (Ba Na, Gia Rai, Xtieng) have low rate of G6PD deficiency (from 1.7 to 3.4%). There was no relationship between the malaria and G6PD deficiency