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Randomized trial of primaquine hypnozoitocidal efficacy when administered with artemisinin-combined blood schizontocides for radical cure of Plasmodium vivax in Indonesia

Overview of attention for article published in BMC Medicine, December 2015
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  • Good Attention Score compared to outputs of the same age (66th percentile)

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4 tweeters

Citations

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42 Dimensions

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86 Mendeley
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Title
Randomized trial of primaquine hypnozoitocidal efficacy when administered with artemisinin-combined blood schizontocides for radical cure of Plasmodium vivax in Indonesia
Published in
BMC Medicine, December 2015
DOI 10.1186/s12916-015-0535-9
Pubmed ID
Authors

Erni J. Nelwan, Lenny L. Ekawati, Bagus Tjahjono, Rianto Setiabudy, Inge Sutanto, Krisin Chand, Tyas Ekasari, Dwi Djoko, Hasan Basri, W. Robert Taylor, Stephan Duparc, Decy Subekti, Iqbal Elyazar, Rintis Noviyanti, Herawati Sudoyo, J. Kevin Baird

Abstract

Safety and efficacy of primaquine against repeated attacks of Plasmodium vivax depends upon co-administered blood schizontocidal therapy in radical cure. We assessed primaquine (PQ) as hypnozoitocide when administered with dihydroartemisinin-piperaquine (Eurartesim®, DHA-PP) or artesunate-pyronaridine (Pyramax®, AS-PYR) to affirm its good tolerability and efficacy. A third arm, artesunate followed by primaquine, was not intended as therapy for practice, but addressed a hypothesis concerning primaquine efficacy without co-administration of blood schizontocide. During March to July 2013, an open-label, randomized trial enrolled Indonesian soldiers with vivax malaria at Sragen, Central Java, after six months duty in malarious Papua, Indonesia. No malaria transmission occurred at the study site and P. vivax recurrences in the 12 months following therapy were classified as relapses. A historic relapse control derived from a cohort of soldiers who served in the same area of Papua was applied to estimate risk of relapse among randomized treatment groups. Those were: 1) AS followed 2d later by PQ (0.5 mg/kg daily for 14d); 2) co-formulated AS-PYR concurrent with the same regimen of PQ; or 3) co-formulated DHA-PP concurrent with the same regimen of PQ. Among 532 soldiers, 219 had vivax malaria during the four months following repatriation to Java; 180 of these were otherwise healthy and G6PD-normal and enrolled in the trial. Subjects in all treatment groups tolerated the therapies well without untoward events and cleared parasitemia within three days. First relapse appeared at day 39 post-enrollment, and the last at day 270. Therapeutic efficacy of PQ against relapse by incidence density analysis was 92 % (95 %CI = 83-97 %), 94 %(95 %CI = 86-97 %), and 95 %(95 %CI = 88-98 %) when combined with AS, AS-PYR, or DHA-PP, respectively. This trial offers evidence of good tolerability and efficacy of PQ against P. vivax relapse when administered concurrently with DHA-PP or AS-PYR. These offer alternative partner drugs for radical cure with primaquine. The AS arm demonstrated efficacy with a total dose of 7 mg/kg PQ without concurrently administered blood schizontocide, another option when primaquine therapy is removed in time from the treatment of the acute malaria or applied presumptively without an attack. Current Controlled Trials ISRCTN82366390 , assigned 20 March 2013.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 86 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 86 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 16%
Researcher 11 13%
Student > Ph. D. Student 11 13%
Lecturer 9 10%
Student > Bachelor 7 8%
Other 11 13%
Unknown 23 27%
Readers by discipline Count As %
Medicine and Dentistry 29 34%
Nursing and Health Professions 7 8%
Pharmacology, Toxicology and Pharmaceutical Science 5 6%
Biochemistry, Genetics and Molecular Biology 4 5%
Agricultural and Biological Sciences 3 3%
Other 13 15%
Unknown 25 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 July 2016.
All research outputs
#3,289,798
of 8,154,593 outputs
Outputs from BMC Medicine
#1,311
of 1,621 outputs
Outputs of similar age
#99,691
of 304,893 outputs
Outputs of similar age from BMC Medicine
#35
of 50 outputs
Altmetric has tracked 8,154,593 research outputs across all sources so far. This one has received more attention than most of these and is in the 59th percentile.
So far Altmetric has tracked 1,621 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.5. This one is in the 18th percentile – i.e., 18% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 304,893 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.
We're also able to compare this research output to 50 others from the same source and published within six weeks on either side of this one. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.