P. falciparum infected patients randomly allocated to this arm will be treated with AS (50mg/tablet) 4 mg/kg body weight once daily for three days followed by DHA-PPQ (40mg of DHA +320mg of PPQ/tablet) once daily for three days.

P. falciparum infected patients randomly allocated to this arm will be treated with the combination DHA-PPQ (40mg of DHA +320mg of PPQ/tablet) once daily for three days.

Drug Resistant Malaria Due to Plasmodium Falciparum

Oral treatment with AS at 4mg/kg/day for 3 days followed by three days of DHA - PPQ in order to insure total parasite clearance. Randomization is done by blocks of ten.

Artesunate (AS) group

Oral treatment with 3-day course of DHA - PPQ. Randomization is done by blocks of ten.

DHA - PPQ group

Chu R Cam commune

P. Falciparum Resistance to Artemisinin in Vietnam

Efficacy of Artesunate Monotherapy and Dihydroartemisinin - Piperaquine in Patients With Uncomplicated Falciparum Malaria in Central Vietnam

Median parasite clearance time (total hours) in both arms (by light microscopy (LM) and quantitative real time PCR (qPCR)) will be computed using the 12-hourly parasite density measurements from day0 till parasite clearance. Parasite clearance time (in hours) will be computed using the Parasite Clearance Estimator tool available online (http://www.wwarn.org/toolkit/data-management/parasite-clearance-estimator).

This outcome is measured at day 28 and 42 of follow-up. Treatment outcomes such as ACPR, early or late clinical failures are defined following WHO guidelines;

Individual and mean IC50 and IC90 values will be computed for each drug using the IVART tool available online (http://www.wwarn.org/tools-resources/toolkit/analyse/ivart)

asexual and sexual parasite forms will be detected by quantitative qPCR and reverse transcription real time PCR (rtPCR), respectively. This outcome will be measured for each sampling time point.

All parasites at day0, and day3 for patients with delayed clearance, will be genotyped for molecular markers of artemisinin resistance (K13 mutations) following a published protocol.

National Institute of Malariology, Parasitology and Entomology, Vietnam

Institute of Tropical Medicine, Belgium

Plasmodium Vivax

efficacy of chloroquine for the treatment of Plasmodium vivax infections

Chloroquine

Chu R Cam

Evaluating the Efficacy of Chloroquine for the Treatment of Plasmodium Vivax Infections in Central Vietnam

This outcome will be measured at day42 of follow-up. Treatment outcomes such as ACPR, early or late clinical failures are defined following WHO guidelines;

asexual parasite forms will be detected by qPCR. This outcome will be measured for each sampling time point.

All parasites at day0 will be genotyped and processed by whole genome sequencing to identify molecular markers of CHL resistance. The same analysis will be done for any P. vivax recurrence occurring during the 42-day follow-up.

All patients will be tested for G6PD deficiency by a rapid test (CareStart) before given the radical cure treatment with primaquine.

sexual parasite forms will be detected by RT-qPCR. This outcome will be measured for each sampling time point.

manihot esculenta/braken

P. Falciparum Resistance to Artemisinin in Vietnam

Evaluating the Efficacy of Chloroquine for the Treatment of Plasmodium Vivax Infections in Central Vietnam

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