Persistent Submicroscopic Plasmodium falciparum Parasitemia 72 Hours after Treatment with Artemether-Lumefantrine Predicts 42-Day Treatment Failure in Mali and Burkina Faso
| Autor: | Issaka Zongo, Khalid B. Beshir, Issaka Sagara, Amidou Diarra, Souleymane Dama, Colin J. Sutherland, Oumar B Traore, Bakary Fofana, Aly Kodio, Nouhoun Barry, Amadou Hamidou Togo, Moctar Coulibaly, Aliou Traore, Sam A. Coulibaly, Ouattara S Maurice, Amadou Bamadio, Issiaka Soulama, Nouhoum Diallo, Frederic Nikiema, Jean-Bosco Ouédraogo, Sodiomon B. Sirima, Abdoulaye Djimde, François Dao, Niawanlou Dara, Jean Moise Kaboré, Naomie Kaboré, Fabrice A. Somé, Yves D Compaore, Salif Sombié |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Artemether/lumefantrine Plasmodium falciparum PLASMODIUM FALCIPARUM PARASITEMIA Parasitemia Clinical Therapeutics Mali law.invention Antimalarials 03 medical and health sciences Randomized controlled trial law Internal medicine Burkina Faso parasitic diseases medicine Humans Pharmacology (medical) Treatment Failure Malaria Falciparum antimalarial agents 030304 developmental biology Pharmacology 0303 health sciences biology 030306 microbiology business.industry Artemether Lumefantrine Drug Combination biology.organism_classification medicine.disease Clinical trial Drug Combinations Infectious Diseases Ethanolamines Day treatment Artemether business After treatment medicine.drug |
| Zdroj: | Antimicrobial Agents and Chemotherapy |
| ISSN: | 1098-6596 0066-4804 |
| DOI: | 10.1128/aac.00873-21 |
| Popis: | A recent randomized controlled trial, the WANECAM (West African Network for Clinical Trials of Antimalarial Drugs) trial, conducted at seven centers in West Africa, found that artemether-lumefantrine, artesunate-amodiaquine, pyronaridine-artesunate, and dihydroartemisinin-piperaquine all displayed good efficacy. However, artemether-lumefantrine was associated with a shorter interval between clinical episodes than the other regimens. In a further comparison of these therapies, we identified cases of persisting submicroscopic parasitemia by quantitative PCR (qPCR) at 72 h posttreatment among WANECAM participants from 5 sites in Mali and Burkina Faso, and we compared treatment outcomes for this group to those with complete parasite clearance by 72 h. Among 552 evaluable patients, 17.7% had qPCR-detectable parasitemia at 72 h during their first treatment episode. This proportion varied among sites, reflecting differences in malaria transmission intensity, but did not differ among pooled drug treatment groups. However, patients who received artemether-lumefantrine and were qPCR positive at 72 h were significantly more likely to have microscopically detectable recurrent Plasmodium falciparum parasitemia by day 42 than those receiving other regimens and experienced, on average, a shorter interval before the next clinical episode. Haplotypes of pfcrt and pfmdr1 were also evaluated in persisting parasites. These data identify a possible threat to the parasitological efficacy of artemether-lumefantrine in West Africa, over a decade since it was first introduced on a large scale. |
| Databáze: | OpenAIRE |
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