Efficacy of Artemether–Lumefantrine for Uncomplicated Plasmodium falciparum Malaria in Cruzeiro do Sul, Brazil, 2016
| Autor: | Marinete Marins Póvoa, Paola Marchesini, Ana carolina Faria e Silva Santelli, Megumi Itoh, Naomi W. Lucchi, Alexandre Macedo de Oliveira, Thayna Maria Holanda de Souza, Stella M. Chenet, Sâmela Farias, Suiane Costa Negreiros do Valle, Giselle Maria Rachid Viana |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Artemether/lumefantrine Adolescent Plasmodium falciparum / parasitologia 030231 tropical medicine 030106 microbiology Plasmodium gallinaceum Parasitemia Drug resistance Efficacy Young Adult 03 medical and health sciences 0302 clinical medicine Regi?o Norte (BR) Virology Internal medicine parasitic diseases medicine Humans Artemether Malaria Falciparum Child Acre (AC) Adverse effect Aged biology business.industry Artemether Lumefantrine Drug Combination Plasmodium falciparum Articles Cruzeiro do Sul (AC) Middle Aged biology.organism_classification medicine.disease Malaria Antimal?ricos / farmacologia Treatment Outcome Infectious Diseases Child Preschool Female Parasitology business Brazil medicine.drug |
| Zdroj: | Repositório Digital do Instituto Evandro Chagas (Patuá) Instituto Evandro Chagas (IEC) instacron:IEC |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | Centers for Disease Control & Prevention. Center for Global Health. Division of Parasitic Diseases and Malaria. Malaria Branch. Atlanta, GA USA. Acre State Health Secretariat. Cruzeiro do Sul, AC, Brazil. Acre State Health Secretariat. Cruzeiro do Sul, AC, Brazil. Acre State Health Secretariat. Cruzeiro do Sul, AC, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Centers for Disease Control & Prevention. Center for Global Health. Division of Parasitic Diseases and Malaria. Malaria Branch. Atlanta, GA USA. Centers for Disease Control & Prevention. Center for Global Health. Division of Parasitic Diseases and Malaria. Malaria Branch. Atlanta, GA USA. Brazilian Ministry of Health. National Malaria Control Program. Brasilia, DF, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Funda??o Oswaldo Cruz. Escola Nacional de Sa?de P?blica S?rgio Arouca. Rio de Janeiro, RJ, Brazil. Centers for Disease Control & Prevention. Center for Global Health. Division of Parasitic Diseases and Malaria. Malaria Branch. Atlanta, GA USA. We evaluated the therapeutic efficacy of artemether?lumefantrine (AL) fixed-dose combination to treat uncomplicated Plasmodium falciparum malaria in Cruzeiro do Sul, Acre State, in the Amazon region of Brazil. Between December 2015 and May 2016, we enrolled 79 patients, 5?79 years old with fever or history of fever in the previous 48 hours and P. falciparum monoinfection confirmed by microscopy. Attempts were made to provide direct observation or phone reminders for all six doses of AL, and patients were followed-up for 28 days. AL was well tolerated, with no adverse events causing treatment interruption. All but one of the 74 patients who completed the 28-day follow-up had an adequate clinical and parasitologic response = 98.6% (95% CI: 93.2-100%). We could not amplify the one isolate of the case with recurrent infection to differentiate between recrudescence and reinfection. Five (6.3%) patients demonstrated persistent asexual parasitemia on Day 3, but none met definition for early treatment failure. We found no mutations in selected kelch13 gene domains, known to be associated with artemisinin resistance in P. falciparum isolates from Day 0. These results strongly support the continued use of AL as a first-line therapy for uncomplicated P. falciparum malaria in Acre. Routine monitoring of in vivo drug efficacy coupled with molecular surveillance of drug resistance markers remains critical. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|