The efficacy of dihydroartemisinin-piperaquine and artemether-lumefantrine with and without primaquine on Plasmodium vivax recurrence: A systematic review and individual patient data meta-analysis.
Robert J CommonsJulie Anne SimpsonKamala ThriemerTesfay AbrehaAbdelmageed ElmugabilNicholas M AnsteyAshenafi AssefaGhulam R AwabJ Kevin BairdBridget E BarberCindy S ChuPrabin DahalAndré DaherTimothy M E DavisArjen M DondorpMatthew J GriggGeorgina S HumphreysJimee HwangHarin KarunajeewaMoses LamanKartini LidiaBrioni R MooreIvo MuellerFrancois H NostenAyodhia Pitaloka PasaribuDhelio Batista PereiraAung Pyae PhyoJeanne Rini PoespoprodjoCarol H SibleyKasia StepniewskaInge SutantoGuy ThwaitesTran T HienNicholas J WhiteTimothy WilliamCharles J WoodrowPhilippe J GuerinRichard N PricePublished in: PLoS medicine (2019)
In this study, we observed the risk of P. vivax recurrence at day 42 to be significantly lower following treatment with DP compared with AL, reflecting the longer period of post-treatment prophylaxis; this risk was reduced substantially by coadministration with PQ. We found that delaying P. vivax recurrence was associated with a small but significant improvement in haemoglobin. These results highlight the benefits of PQ radical cure and also the provision of blood-stage antimalarial agents with prolonged post-treatment prophylaxis.