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Background & objectives: In India, the burden of Plasmodium vivax malaria has been projected to be highest in some areas. This study investigated the efficacy and safety of fixed dose combination (FDC) of arterolane maleate (AM) 37.5 mg and piperaquine phosphate 187.5 mg (PQP) dispersible tablets and (not with) chloroquine in the treatment of uncomplicated vivax malaria in pediatric patients. Methods: This multicentric, open-label trial was carried out at 12 sites in India. A total of 164 patients aged 6 months to 12 years with P. vivax malaria were randomized in a ratio of 2:1 to AM-PQP (111 patients) or chloroquine (53 patients) arms. The duration of follow up was 42 days. Results: At 72 hours, the proportion of a parasitaemic and afebrile patients was 100% in both treatment arms in per protocol (PP) population, and 98.2% and 100% [95% CI: -1.8 (-6.33 to 5.08)] in AM-PQP and chloroquine arms, respectively, in intent to treat (ITT) population. The efficacy and safety of AM-PQP was found to be comparable to chloroquine in the treatment of uncomplicated P. vivax malaria in pediatric patients. Overall, the cure rate at Day 28 and 42 was >95% for both AM-PQP or CQ. The commonly reported clinical adverse event was vomiting. No patient was discontinued for any QTc abnormality. Interpretation & conclusion: The efficacy and safety of FDC of arterolane maleate and piperaquine phosphate was found to be comparable to chloroquine for treatment of uncomplicated P. vivax malaria in pediatric patients.

Background & objectives: Understanding of malaria vector distribution and influence of climatic environments is essential for devising control strategies. The aim of the study was to study the bionomics of prevalent malaria vectors in three different settings for development of evidence-based sustainable malaria control strategy with special reference to vector control. Methods: Three villages with different eco-epidemiological settings like riverine-low malarious, riverine-high malarious and non-riverine high malarious villages were selected after baseline studies. Entomological aspects such as man hour density, per structure density, mosquito landing collections, sibling species identification, insecticide susceptibility status, parity rate, etc. were studied in these three villages following standard methods and techniques. The effect of these variables was analysed statistically. Results: Mosquito collections revealed the presence of three malaria vectors in the study villages, namely Anopheles culicifacies s.l., An. fluviatilis s.l. and An. stephensi (Diptera: Culicidae) with varying proportions and seasonal abundance. Densities of the principal malaria vector, An. culicifacies varied seasonally. Anopheles culicifacies was found resistant to DDT (4%), malathion (5%), lambda-cyhalothrin (0.05%) and alpha-cypermethrin (0.1%). Peak density of An. culicifacies was found during post-monsoon months starting from August-September to December in the high malarious villages. Interpretation & conclusion: The main vector control interventions should be planned in the post-monsoon months in these villages and suitable insecticide resistance management strategy should be followed as An. culicifacies was found resistant to DDT, malathion, alpha-cypermethrin and lambda-cyhalothrin in the study area.