Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study

Artemisinin-naphthoquine (ART-NQ) is a fixed-dose coformulated antimalarial therapy recommended as a single-dose treatment and marketed in Papua New Guinea among other tropical countries. We conducted a tolerability, safety, and efficacy study of ART-NQ for Papua New Guinean children aged 5 to 12 ye...

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Main Authors: Benjamin, J., Moore, Brioni, Lee, S., Senn, M., Griffin, S., Lautu, D., Salman, S., Siba, P., Mueller, I., Davis, T.
Format: Journal Article
Published: American Society for Microbiology 2012
Online Access:http://hdl.handle.net/20.500.11937/43122
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author Benjamin, J.
Moore, Brioni
Lee, S.
Senn, M.
Griffin, S.
Lautu, D.
Salman, S.
Siba, P.
Mueller, I.
Davis, T.
author_facet Benjamin, J.
Moore, Brioni
Lee, S.
Senn, M.
Griffin, S.
Lautu, D.
Salman, S.
Siba, P.
Mueller, I.
Davis, T.
author_sort Benjamin, J.
building Curtin Institutional Repository
collection Online Access
description Artemisinin-naphthoquine (ART-NQ) is a fixed-dose coformulated antimalarial therapy recommended as a single-dose treatment and marketed in Papua New Guinea among other tropical countries. We conducted a tolerability, safety, and efficacy study of ART-NQ for Papua New Guinean children aged 5 to 12 years with uncomplicated malaria, comparing single-dose ART-NQ (15 and 6 mg/kg of body weight) given with water (group 1; n = 15), single-dose ART-NQ (22 and 9 mg/kg) given with milk (group 2; n = 17), or two daily doses of 22 and 9 mg/kg given with water (group 3; n = 16). Of the 48 children (45 with Plasmodium falciparum malaria, 2 with Plasmodium vivax malaria, and 1 with mixed-species malaria), 2 in group 2 did not attend all follow-up assessments. All regimens were well tolerated, with no serious adverse events. There were no clinically significant changes in pulse, blood pressure, rate-corrected electrocardiographic QT, routine biochemistry/hematology, or hearing after treatment. Fever clearance was prompt. Mean 50% parasite clearance times were 4, 4, and 5 h for groups 1, 2, and 3, respectively. One group 1 patient had PCR-confirmed P. falciparum recrudescence at day 23; four had PCR-confirmed P. falciparum reinfections on day 28 or 42; and three had P. vivax infections detected on day 42. The only recurrent parasitemia in groups 2 and 3 occurred in a group 2 child who developed a P. vivax infection on day 42. Day 14 gametocyte positivity levels were 20%, 27%, and 9% in groups 1, 2, and 3, respectively. The lower single ART-NQ dose was associated with relatively frequent recurrence of parasitemia, but the prolonged gametocytemia in all three groups has implications for the transmission of malaria. Copyright © 2012, American Society for Microbiology. All Rights Reserved.
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spelling curtin-20.500.11937-431222023-02-22T06:24:16Z Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study Benjamin, J. Moore, Brioni Lee, S. Senn, M. Griffin, S. Lautu, D. Salman, S. Siba, P. Mueller, I. Davis, T. Artemisinin-naphthoquine (ART-NQ) is a fixed-dose coformulated antimalarial therapy recommended as a single-dose treatment and marketed in Papua New Guinea among other tropical countries. We conducted a tolerability, safety, and efficacy study of ART-NQ for Papua New Guinean children aged 5 to 12 years with uncomplicated malaria, comparing single-dose ART-NQ (15 and 6 mg/kg of body weight) given with water (group 1; n = 15), single-dose ART-NQ (22 and 9 mg/kg) given with milk (group 2; n = 17), or two daily doses of 22 and 9 mg/kg given with water (group 3; n = 16). Of the 48 children (45 with Plasmodium falciparum malaria, 2 with Plasmodium vivax malaria, and 1 with mixed-species malaria), 2 in group 2 did not attend all follow-up assessments. All regimens were well tolerated, with no serious adverse events. There were no clinically significant changes in pulse, blood pressure, rate-corrected electrocardiographic QT, routine biochemistry/hematology, or hearing after treatment. Fever clearance was prompt. Mean 50% parasite clearance times were 4, 4, and 5 h for groups 1, 2, and 3, respectively. One group 1 patient had PCR-confirmed P. falciparum recrudescence at day 23; four had PCR-confirmed P. falciparum reinfections on day 28 or 42; and three had P. vivax infections detected on day 42. The only recurrent parasitemia in groups 2 and 3 occurred in a group 2 child who developed a P. vivax infection on day 42. Day 14 gametocyte positivity levels were 20%, 27%, and 9% in groups 1, 2, and 3, respectively. The lower single ART-NQ dose was associated with relatively frequent recurrence of parasitemia, but the prolonged gametocytemia in all three groups has implications for the transmission of malaria. Copyright © 2012, American Society for Microbiology. All Rights Reserved. 2012 Journal Article http://hdl.handle.net/20.500.11937/43122 10.1128/AAC.06248-11 American Society for Microbiology unknown
spellingShingle Benjamin, J.
Moore, Brioni
Lee, S.
Senn, M.
Griffin, S.
Lautu, D.
Salman, S.
Siba, P.
Mueller, I.
Davis, T.
Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study
title Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study
title_full Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study
title_fullStr Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study
title_full_unstemmed Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study
title_short Artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: A tolerability, safety, and preliminary efficacy study
title_sort artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria: a tolerability, safety, and preliminary efficacy study
url http://hdl.handle.net/20.500.11937/43122