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Table 4 Annual clinical and parasite responses to dihydroartemisinin-piperaquine treatment of uncomplicated Plasmodium falciparum malaria in Gia Lai province, Vietnam

From: Rapid decline in the susceptibility of Plasmodium falciparum to dihydroartemisinin–piperaquine in the south of Vietnam

Characteristic

2011 (n = 21)

2015 (n = 27)

P value*

Parasite clearance time (PCT100)

 Median (IQR) [hours]

36 (30,42)

96 (54, NA)

<0.001

 Proportion with PCT > 72 h

0% (0/21)

55% (15/55)

Parasite clearance half- life T1/2 [hours]

 Median (IQR)

1.97 (1.66, 2.59)

6.88 (2.84, 7.74)

<0.001

 Geometric mean (95% CI)

2.19 (1.86, 2.59)

5.19 (4.07, 6.62)

 T1/2 > 5 h

0/21 (0%)

18/26 (69%)

Fever clearance time [hours]

Median (IQR) [hours]

30 (18.30)

36 (24.54)

0.001

Treatment outcome (WHO)

 APCR#

17/21 (81%)

24/27 (89%)

 Early treatment failure

0/21 (0%)

0/27 (0%)

 Clinical treatment failure

0/21 (0%)

0/27 (0%)

 Parasitological treatment failure

0/21 (0%)

2/27 (7%)

 Withdrawal

2/21 (10%)

0/27 (0%)

 Loss to follow-up

2/21 (10%)

1/27 (4%)

Risk of failure [PCR-uncorrected]

 Uncorrected Kaplan–Meier estimate (ITT)

0%

8%

0.22

 Uncorrected proportion (per protocol)

0/17 (0%)

2/26 (8%)

0.22

Risk of failure [PCR-corrected]

 Corrected Kaplan–Meier estimate (ITT)

0%

0%

 Corrected proportion (per protocol)

0/17 (0%)

0/24 (0%)

 K13-propeller mutation

0/20 (0%)

C580Y:18/27 (67%)

Y493H:2/27 (7%)

Total 20/27 (74%)

<0.001

  1. * P values are based on linear trend tests
  2. APCR adequate clinical and parasitological responses