Artemisinin for malaria in Vietnam: Aspects of efficacy and safety

Abstract

Malaria is an important aspect of public health in endemic countries, not in the least because malaria control is frustrated by the spreading risk of (multi‐)drug resistant malaria. Many strategies and campaigns for malaria control were launched during the last century. However, notwithstanding certain successes, the safety of much of the population the malaria endemic regions is threatened by drug resistant malaria parasites. The current “Global Malaria Control Strategy” aims at application of artemisinin based combination therapy (ACT). Some nations have been particularly successful in applying ACT, such as China, Vietnam, Thailand, and Brazil. Artemisinin derivatives are very effective agents and safe for human use. Fetal neurotoxicity, as was found in animal experiments, has not been observed in humans, but it is acknowledged that data aggregation and post marketing surveillance are not yet optimal to exclude potential risks by the use of ACT. This paper describes a series studies of the use of artemisinins as monotherapy or in combination with mefloquine or piperaquine, also in comparison to a combination of atovaquone/proguanil for the treatment of P. falciparum and P. vivax malaria in the South of Vietnam.