학술논문
Malaria parasite clearance from patients following artemisinin-based combination therapy in Cote d'Ivoire
Document Type
Report
Author
Source
Infection and Drug Resistance. Annual, 2018, Vol. 12, p2031, 8 p.
Subject
Language
English
ISSN
1178-6973
Abstract
Introduction: Parasite clearance is useful to detect artemisinin resistance. The aim of this study was to investigate parasite clearance in patients treated with artesunate + amodiaquine (AS + AQ) and artemether + lumefantrine (AL): the two artemisinin-based combination therapies (ACTs) recommended in the first-line treatment of uncomplicated malaria in Cote d'Ivoire. Methods: This study was conducted in Bouake, Cote d'Ivoire, from April to June 2016. Patients aged at least 6 months with uncomplicated malaria and treated with AS + AQ or AL were hospitalized for 3 days, and follow-up assessments were performed on days 3, 7, 14, 21, 28, 35, and 42. Blood smears were collected at the time of screening, pre-dose, and 6-hour intervals following the first dose of administration until two consecutive negative smears were recorded, thereafter at day 3 and follow-up visits. Parasite clearance was determined using the Worldwide Antimalarial Resistance Network's parasite clearance estimator. The primary end points were parasite clearance rate and time. Results: A total of 120 patients (57 in the AS + AQ group and 63 in the AL group) were randomized among 298 patients screened. The median parasite clearance time was 30 hours (IQR, 24-36 hours), for each ACT. The median parasite clearance rate had a slope half-life of 2.36 hours (IQR, 1.85-2.88 hours) and 2.23 hours (IQR, 1.74-2.63 hours) for AS + AQ and AL, respectively. The polymerase chain reaction-corrected adequate clinical and parasitological response was 100% and 98.07% at day 42 for AS + AQ and AL, respectively. Conclusion: Patients treated with AS + AQ and AL had cleared parasites rapidly. ACTs are still efficacious in Bouake, Cote d'Ivoire, but continued efficacy monitoring of ACTs is needed. Keywords: Plasmodium falciparum, ACTs, parasite clearance, Cote d'Ivoire
Introduction Malaria remains a serious public health problem in sub-Saharan Africa despite the reduction in morbidity and mortality observed in recent years. (1) The advances in the control of malaria [...]
Introduction Malaria remains a serious public health problem in sub-Saharan Africa despite the reduction in morbidity and mortality observed in recent years. (1) The advances in the control of malaria [...]