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At the 50th Anniversary of Project 523,we reviewed the course and progress made by the Artemisinin Anti-malaria Research Group of Guangzhou University of Chinese Medicine in the application of artemisinin for treating malaria.As one of the groups participating in the mission of Project 523,Artemisinin Anti-malaria Research Group of Guangzhou University of Chinese Medicine was in charge of the clinical trials in treating malaria with artemisinin and its derivatives of various preparation forms,dosages and treatment courses(years 1974-1989),developed the artemisinin-based combinations(ACTs) Artekin and Artequick for malaria treatment and performed their clinical trials(years 1984-2006).For the recent 10 years,the group has been devoted in the implementation of anti-malaria programme FEMSE (Fast Elimination of Malaria by Source Eradication) in south-east Asia and Africa.The scientific explorations and achievements of this research group have made great contribution in bringing artemisinins to the world and creating a simple,practical and cost-effective new method for rapid global malaria elimination.
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Objective To investigate the therapeutic effect of the method of Fast Elimination of Malaria by Source Eradication (FEMSE) in Moheli island of Comoros. Methods Based on the FEMSE project, parasite positive cases were given a standard treatment course of ARTEQUICK (artemisinin plus piperaquine) plus primaquine: two tablets for adults at 0 hour and two tablets at 24 hours, a total of 4 tablets during one treatment course. One time of Mass Drug Administration (MDA) was for the children with parasite carrier rate less than 10%. Two times of MDA was for the children with parasite carrier rate more than 10%, and the interval between the two MDA was 42 days. Coverage rate for MDA and population carrier rate were observed. Results The number of people taking the first MDA of Artequick-Primaquine was 32,519 (the whole population registered at the same time being 37,243, 367 infants under 6 months old not involved), and the coverage rate for MDA was 88.2%. The population involved in the second MDA was 35,370 (the whole population registered at the same time being 37,112, 335 infants under 6 months old not involved), and the coverage rate for MDA was 96. 2%. Parasite carrier rate was 22.95% (281/ 1,224) before MDA, 1.41% (28/1, 987) two months after MDA and 0. 33% (8/2,458) four months after MDA, with a decrease of 98.56% . Conclusion The decrease of parasite carrier rate from 22. 95% to 0. 33% before and after MDA indicates that MDA of Artequick-Primaquine based on FEMSE can decrease the parasite carrier rate in a short time, without any obvious side effects. Further decrease of parasite carrier rate and incidence will be achieved if the measures for clearing malaria are fully implementated during the consolidation phase.
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To determine the optimum dose of artemisinin-piperaquine combination therapies for acute uncomplicated Plasmodium falciparum malaria, we examined 7 candidate regimens in 411 patients admitted to the Bangkok Hospital for Tropical Diseases. The studies were performed from May 2005 to October 2005 and November 2005 to June 2006. We compared 3-day courses of artesunate-mefloquine, artemether-lumefantrine (Coartem) and of dihydroartemisinin-piperaquine (Artekin) as reference antimalarial treatments, with candidate regimens using 2-3 day courses of artemisinin-piperaquine, Artequick. Initially, patients receiving each of the regimens had a rapid clinical and parasitological response. All treatments were well tolerated and no serious adverse effects occurred. The 28-day cure rates were < 80% for the 2-day treatments with artemisinin-piperaquine at 2.4 mg/kg and 14.4 mg/kg, respectively, in the first study period and artemisinin-piperaquine at 3.2 mg/kg and 16.0 mg/kg, respectively, but > 98% for the 3-day regimens. These results suggest that a 3-day course of artemisinin-piperaquine at 3.2 mg/kg and 16.0 mg/kg, respectively, deserve further evaluation as an alternative treatment for multidrug-resistant P. falciparum malaria.
Subject(s)
Acute Disease , Adolescent , Adult , Anti-Infective Agents/administration & dosage , Antimalarials/administration & dosage , Artemisinins/administration & dosage , Drug Therapy, Combination , Female , Humans , Malaria, Falciparum/drug therapy , Male , Middle Aged , Prospective Studies , Quinolines/administration & dosage , ThailandABSTRACT
Objective To compare the effects of dual-wavelength spectrophotometry and HPLC on the content of trimethoprim(TMP)in Compound Dihydroartemisinin Tablets.Methods HPLC was performed in a column of C 18 with acetonitrile and 0.75% diethylamine(15∶85,adjusting pH to 2.5 by phosphoric acid)as the mobile phase and the detecting wavelength was at 271nm.The detecting wavelength was also at 271nm with reference wavelength at 366nm in dual-wavelength spectrophotomerty.Results Within 20.0～100.0 ?g/mL,TMP has a good linearity(r=0.999 94)by HPLC,and the average recovery was 100.9% with RSD being0.24%(n=5).By dual-wavelength spectrophotometry,a good linearity(r=0.999 95)of TMP was within 5.0～25.0 ?g/mL,and the average recovery was 100.0% with RSD being 0.45%(n=5).Conclusion Both dual-wavelength spectrophotometry and HPLC can be used to determine the content of TMP in Compound Dihydroartemisinin Tablets,but the former can detect the content of TMP directly without the disturbance of piperaquine phosphate and is simple,rapid and accurate.
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0.05).The cure rate was 100%and parasite recrudescence rate was zero in both groups,the difference being insignificant.The incidence of adverse reaction was lower in Artekin group.【Conclusion】Artecom and Artekin have similar therapeutic effect on uncomplicated falciparum malaria,but Artekin without trimethoprim has lower adverse reactions,thus it is recommended for clinical use.
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A study was carried out in south of Vietnam 15 Patients with Plasmodium falciparum gametocytes and asexual parasites were distributed into groups A, B and C. Artesunate was given orally at a total dose of 600 mg for 5 days in group A, 200 mg for 2 days in group B and intravenously at a total dose of 360 mg for 5 days in group C respectively. Gametocytes count was done before medication and daily after medication. Meanwhile, Anopheles dirus as a vector was employed to study the infectivity of gametocyte, The result showed that the mean gametocyte clearance time in three groups were respectively 15.4?5.0, 20.6?4.8 and 20.3?4.0 days. The mosquitoes were not infected from the blood in 2, 5 and 5 of 5 patients respectively on days 7, 14 and 21 in group A; 1 and 5 of 5 patients on day 14 and 21 in group B; 2 of 5 patients and 3 of 3 patients on days 14 and 21 in group C. It indicates that artesunate has remarkable effect on Plasmodium falciparum gametocytemia and its infectivity to mosquitoes.