{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T09:07:13Z","timestamp":1789895233587,"version":"4.0.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T00:00:00Z","timestamp":1590019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Belgium Development Cooperation"},{"name":"Framework Agreement Program between DGD and ITM"},{"name":"MalariaGEN Resource Centre supported by Wellcome","award":["098051"],"award-info":[{"award-number":["098051"]}]},{"name":"MalariaGEN Resource Centre supported by Wellcome","award":["090770"],"award-info":[{"award-number":["090770"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Artemisinin-based combination therapies (ACTs) have significantly contributed to reduce Plasmodium falciparum malaria burden in Vietnam, but their efficacy is challenged by treatment failure of dihydroartemisinin\/piperaquine ACT in Southern provinces.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the efficacy of dihydroartemisinin\/piperaquine for uncomplicated P. falciparum malaria in Gia Lai, Central Vietnam, and determine parasite resistance to artemisinin (ClinicalTrials.gov identifier NCT02604966).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Sixty patients received either dihydroartemisinin\/piperaquine (4\u2009mg\/kg\/day, 3\u2009days; n\u2009=\u200933) or artesunate monotherapy (4\u2009mg\/kg\/day, 3\u2009days; n\u2009=\u200927) followed by dihydroartemisinin\/piperaquine (AS + DHA\/PPQ). Clinical phenotypes were determined during a 42 day follow-up and analysed together with ex vivo susceptibility to antimalarials and molecular markers of drug resistance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Day 3 positivity rate was significantly higher in the AS + DHA\/PPQ arm compared with dihydroartemisinin\/piperaquine (70.4% versus 39.4%, P\u2009=\u20090.016). Parasite clearance time was 95.2\u2009h (AS + DHA\/PPQ) versus 71.9\u2009h (dihydroartemisinin\/piperaquine, P\u2009=\u20090.063) and parasite clearance half-life was 7.4\u2009h (AS + DHA\/PPQ) versus 7.0\u2009h (dihydroartemisinin\/piperaquine, P\u2009=\u20090.140). Adequate clinical and parasitological response at Day 42 was 100% in both arms. By RT\u2013qPCR, 36% (19\/53) patients remained positive until Day 7. No recurrences were detected. kelch13 artemisinin resistance mutations were found in 87% (39\/45) of isolates and 50% (20\/40) were KEL1\/C580Y. The piperaquine resistance marker plasmepsin-2 was duplicated in 10.4% (5\/48). Isolates from Day 3-positive patients (n\u2009=\u200918) had higher ex vivo survival rates to artemisinin compounds (P\u2009&amp;lt;\u20090.048) and prevalence of kelch13 mutations (P\u2009=\u20090.005) than Day 3-negative patients (n\u2009=\u20095). The WHO definition of artemisinin resistance was fulfilled in 60% (24\/40) of cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although dihydroartemisinin\/piperaquine remained effective to treat P. falciparum, the high Day 3 positivity rate and prevalence of KEL1 strains calls for continuous monitoring of dihydroartemisinin\/piperaquine efficacy in Central Vietnam.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaa172","type":"journal-article","created":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T19:10:10Z","timestamp":1586373010000},"source":"Crossref","is-referenced-by-count":11,"title":["Efficacy of dihydroartemisinin\/piperaquine and artesunate monotherapy for the treatment of uncomplicated Plasmodium falciparum malaria in Central 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Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Thi Thu","family":"Hien","sequence":"first","affiliation":[{"name":"National Institute of Malariology, Parasitology and Entomology, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Thi Hong","family":"Ngoc","sequence":"first","affiliation":[{"name":"National Institute of Malariology, Parasitology and Entomology, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Guetens","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Luong","family":"Hieu","sequence":"first","affiliation":[{"name":"National Institute of Malariology, Parasitology and Entomology, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran 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