Delayed Plasmodium falciparum clearance following artesunate-mefloquine combination therapy in Thailand, 1997–2007
| Autor: | Saowanit Vijaykadga, John R. MacArthur, Steven R. Meshnick, Wichai Satimai, Alisa P. Alker, Chansuda Wongsrichanalai |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Time Factors Drug Resistance Artesunate Parasitemia Drug resistance chemistry.chemical_compound Malaria Falciparum Child Aged 80 and over parasite clearance biology Mefloquine Middle Aged Thailand Artemisinins Treatment Outcome Infectious Diseases Child Preschool Drug Therapy Combination Female medicine.drug Adult medicine.medical_specialty lcsh:Arctic medicine. Tropical medicine Adolescent Combination therapy lcsh:RC955-962 Plasmodium falciparum lcsh:Infectious and parasitic diseases Antimalarials Young Adult Internal medicine parasitic diseases medicine Humans lcsh:RC109-216 Aged Retrospective Studies business.industry Research Retrospective cohort study medicine.disease biology.organism_classification Malaria chemistry Immunology Parasitology business |
| Zdroj: | Malaria Journal Malaria Journal, Vol 11, Iss 1, p 296 (2012) |
| ISSN: | 1475-2875 |
| DOI: | 10.1186/1475-2875-11-296 |
| Popis: | Background There is concern that artesunate resistance is developing in Southeast Asia. The purpose of this study is to investigate the prevalence of parasitaemia in the few days following treatment with artesunate-mefloquine (AM), which is an indirect measure of decreased artesunate susceptibility. Methods This is a retrospective analysis of 31 therapeutic efficacy studies involving 1,327 patients treated with AM conducted by the Thai National Malaria Control Programme from 1997–2007. Results The prevalence of patients with parasitaemia on day 2 was higher in the east compared to the west (east: 20%, west: 9%, OR 2.47, 95% CI: 1.77, 3.45). In addition, the prevalence of day-2 parasitaemia increased over time (OR for each year = 1.10, 95% CI: 1.03, 1.19). After controlling for initial parasitaemia and age, year and region remained important determinants of day-2 parasitaemia (OR for region = 3.98, 95%CI 2.63, 6.00; OR for year = 1.28, 95%CI: 1.17, 1.39). The presence of parasitaemia on day 2 and day 3 were specific, but not sensitive predictors of treatment failure. Discussion Delayed resolution of parasitaemia after AM treatment increased in eastern Thailand between 1997 and 2007, which may be an early manifestation of decreased artesunate susceptibility. However, clinical and parasitological treatment failure after 28 days (which is related to both mefloquine and artesunate decreased susceptibility) is not changing over time. The presence of parasitaemia on day 2 is a poor indicator of AM 28-day treatment failure. |
| Databáze: | OpenAIRE |
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