Chloroquine/doxycycline combination versus chloroquine alone, and doxycycline alone for the treatment of Plasmodium falciparum and Plasmodium vivax malaria in northeastern Irian Jaya, Indonesia. |
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Authors: | W R Taylor H Widjaja T L Richie H Basri C Ohrt Taufik" target="_blank">E TjitraTaufik T R Jones K C Kain S L Hoffman |
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Institution: | United States Naval Medical Research Unit Number 2, Jakarta, Indonesia. |
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Abstract: | Combination therapy is one method of overcoming the global challenge of drug-resistant Plasmodium falciparum malaria. We conducted a hospital-based 28-day in vivo test comparing chloroquine/doxycycline to chloroquine or doxycycline alone for treating P. falciparum and Plasmodium vivax malaria in Irian Jaya, Indonesia. Eighty-nine patients with uncomplicated falciparum malaria were randomized to standard dose chloroquine (n = 30), doxycycline (100 mg every 12 hours 7 days], n = 20), or chloroquine with doxycycline (n = 39); corresponding numbers for vivax malaria (n = 63) were 23, 16, 24. Endpoints were parasite sensitivity (S) or resistance (RI/RII/RIII). Of the 105 evaluable patients, chloroquine/doxycycline cured (S) 20/22 (90.9% 95% CI 78.9-100%]) patients with P. falciparum malaria; 2/22 (9.1% 0-21%]) were RIII resistant. Doxycycline cured 11/17 (64.7% 42.0-87.4%]) patients, and chloroquine 4/20 (20% 2.5-37.5%]). Against P. vivax, chloroquine/doxycycline cured (S) 12/17 (70.6% 48.9-92.2%]) patients, doxycycline 4/12 (33.3% 6.6-59.9%]), and chloroquine 5/17 (29.4% 7.7-51.1%]). Chloroquine/doxycycline was effective against P. falciparum but only modestly effective against P. vivax. These findings support the use of chloroquine/doxycycline as an inexpensive alternative to mefloquine for treating chloroquine-resistant P. falciparum but not chloroquine-resistant P. vivax in this setting. |
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