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The efficacy of DHA\u2013PPQ was evaluated in 2 sentinel sites in Keerom District, Papua and Merangin District, Jambi, Sumatra from April 2017 to April 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical and parasitological parameters were monitored over a 42-day period following the World Health Organization standard in vivo protocol and subjects meeting the inclusion criteria were treated with DHA\u2013PPQ once daily for 3\u00a0days, administered orally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In Papua, 6339 subjects were screened through active and passive cases detection. Of the 114 falciparum and 81 vivax cases enrolled, 102 falciparum and 80 vivax cases completed the 42\u00a0day follow up, and 12 falciparum and 1 vivax cases were either lost to follow up or withdrawn. Kaplan\u2013Meier analysis of microscopy readings of 102 falciparum cases revealed 93.1% (95% CI 86.4\u201397.2) as Adequate Clinical and Parasitological Response (ACPR). No delay in parasite clearance nor severe adverse reaction was observed. Recurrent parasites of\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      were detected in 7 cases and categorized as late treatment failures (LTF) at days 21, 35, and 42 and one of which was reinfected by\n                      <jats:italic>Plasmodium vivax<\/jats:italic>\n                      at day 42. Two cases were confirmed as recrudescent infection and 4 were re-infection. The PCR-corrected DHA\u2013PPQ efficacy for\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      was 97.9% (95% CI 92.7\u201399.7). Of the 80 cases of\n                      <jats:italic>P. vivax<\/jats:italic>\n                      that were followed up, 71 cases were completely cured and classified as ACPR (88.8%, 95% CI 79.7\u201394.7) and 9 cases showed recurrent infection at days 35 and 42, and classified as LTF. In Sumatra, of the 751 subjects screened, 35 vivax subjects enrolled, 34 completed the 42\u00a0day follow up. Thirty-three cases were completely cured and classified as ACPR (97.1%, 95% CI 84.7\u201399.9) and 1 recurrent infection was observed and classified as LTF. No delay in parasite clearance nor severe adverse reaction was observed. Analysis of the\n                      <jats:italic>Pfk13<\/jats:italic>\n                      gene in\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      cases from Papua revealed no mutations associated with artemisinin resistance in the 20 SNPs previously reported. Analysis of the\n                      <jats:italic>Pfpm2<\/jats:italic>\n                      gene at day 0 and day of recurrence in recrudescent cases revealed the same single copy number, whereas 3 of the 4 re-infection cases carried 2\u20133\n                      <jats:italic>Pfpm2<\/jats:italic>\n                      gene copy numbers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Treatment of falciparum and vivax malaria cases with DHA\u2013PPQ showed a high efficacy and safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-022-04101-0","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T09:02:36Z","timestamp":1647680556000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Efficacy and safety of dihydroartemisinin\u2013piperaquine for the treatment of uncomplicated Plasmodium falciparum and Plasmodium vivax malaria in Papua and Sumatra, Indonesia"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4582-9133","authenticated-orcid":false,"given":"Puji B. 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The trial was registered with the clinical trial number ACTRN12616001533482.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"HHB and MDGB are staff member of the World Health Organization and are responsible for the views expressed in this publication, which do not necessarily reflect the decisions or policies of the World Health Organization.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}],"article-number":"95"}}