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Int J Parasitol Drugs Drug Resist. 2017 Aug;7(2):181-190. doi: 10.1016/j.ijpddr.2017.03.003. Epub 2017 Mar 24.

The Vivax Surveyor: Online mapping database for Plasmodium vivax clinical trials.

Author information

1
Global Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; WorldWide Antimalarial Resistance Network, UK. Electronic address: robert.commons@gmail.com.
2
Global Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
3
WorldWide Antimalarial Resistance Network, UK; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
4
WorldWide Antimalarial Resistance Network, UK.
5
WorldWide Antimalarial Resistance Network, UK; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Department of Genome Sciences, University of Washington, Seattle, USA.
6
Global Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; WorldWide Antimalarial Resistance Network, UK; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.

Abstract

INTRODUCTION:

Recurrent P. vivax infections are associated with significant morbidity and mortality. Although radical cure can reduce recurrent infection, it is confounded by antimalarial resistance and the lack of safe and effective hypnozoitocidal treatment. This study documents the available literature of published clinical trials of P. vivax, providing an up to date, online, open access tool to view and download available information.

METHODS:

A systematic review was conducted according to PRISMA guidelines to identify prospective P. vivax therapeutic clinical trials with at least 28 days follow-up published between 1st January 1960 and 12th October 2016. Treatment arms and evidence of chloroquine resistance were mapped to trial sites.

RESULTS:

Since 1960, a total of 1152 antimalarial clinical trials with a minimum 28 days follow-up have been published, of which 230 (20.0%) enrolled patients with P. vivax and were included. Trials were conducted in 38 countries: 168 (73.0%) in the Asia-Pacific, 13 (5.7%) in Africa and 43 (18.7%) in the Americas. The proportion of antimalarial trials assessing P. vivax rose from 10.7% (12/112) in 1991-1995, to 24.9% (56/225) in 2011-2015. Overall, 188 (81.7%) P. vivax trials included a chloroquine treatment arm, either alone or in combination with primaquine, and 107 (46.5%) trials included a chloroquine treatment arm with early primaquine to assess radical cure. There has been a recent increase in treatment arms with artemisinin derivatives. Of the 131 sites in which chloroquine resistance could be quantified, resistance was present in 59 (45.0%) sites in 15 endemic countries.

CONCLUSIONS:

Over the last 20 years there has been a substantial increase in clinical research on the treatment of P. vivax, which has generated a greater awareness of the global extent of chloroquine resistance. The WWARN open access, online interactive map provides up to date information of areas where drug resistant P. vivax is emerging.

KEYWORDS:

Clinical trial; Open access; Plasmodium vivax; Resistance; Review; Treatment

PMID:
28384505
PMCID:
PMC5382033
DOI:
10.1016/j.ijpddr.2017.03.003
[Indexed for MEDLINE]
Free PMC Article

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