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Am. J. Trop. Med. Hyg., 78(4), 2008, pp. 543-545
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Dihydroartemisinin—Piperaquine Rescue Treatment of Multidrug-resistant Plasmodium falciparum Malaria in Pregnancy: A Preliminary Report

Marcus J. Rijken, Rose McGready, Machteld E. Boel, Marion Barends, Stephane Proux, Mupawjay Pimanpanarak, Pratap Singhasivanon, AND François Nosten*
Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Academic Medical Center, Amsterdam, The Netherlands; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand; Centre for Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, United Kingdom

 

ABSTRACT

Dihydroartemisinin-piperaquine (DHA-PPQ) is a promising new artemisinin combination treatment. There are no published data on the intentional use of the drug in pregnancy. Between June 2006 and January 2007, 50 Karen pregnant women with recurrent P. falciparum infections, despite 7-day treatments with quinine or artesunate (+/–clindamycin) or both, were treated with DHA-PPQ. This rescue treatment was effective and well tolerated and there was no evidence of toxicity for the mothers or the fetus. The PCR adjusted cure rate by Kaplan Meier analysis at day 63 was 92.2% (95% CI: 76.9–97.4).

Received June 14, 2007. Accepted for publication December 25, 2007.

Acknowledgments: The authors thank all the staff of the Shoklo Malaria Research Unit, especially Suleeporn Parnpeeya, Wimon, Supor Keereecharoen, Ratri Arunjerdja, Saw Oo Tan, Aung Pyae Phyo, Carit Ler Moo, Lay Lay, Candy Beau, Claudia Turner, Verena Carrara, Khin Maung Lwin, Anchalee Jaidee, Nathapon Laochan, Julian Zwang, Siam, and Carela. Dihyroartemisinin-piperaquine was kindly provided by Holley Cotec Pharmaceutical, Guangzhou, China.

Financial support: The Shoklo Malaria Research Unit is part of the Mahidol Oxford University Research Programme, funded by the Wellcome Trust of Great Britain.

* Address correspondence to François Nosten, Shoklo Malaria Research Unit, PO Box 46, 63110 Mae Sot, Tak, Thailand. E-mail: SMRU{at}tropmedres.ac

All authors have no conflict of interest.

Authors’ addresses: Marcus J. Rijken, Rose McGready, Machteld E. Boel, Marion Barends, Stephane Proux, Mupawjay Pimanpanarak, and François Nosten, Shoklo Malaria Research Unit, PO Box 46, 63110 Mae Sot, Tak, Thailand, Tel: +66-55-545021, Fax: +66-55-545020, E-mail: SMRU{at}tropmedres.ac. Pratap Singhasivanon, Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchadewee, Bangkok 10400, Thailand, Tel: +66-2-354-9100, Fax: +66-2-354-9198.






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