Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018

Autor: Leah F. Moriarty, Didier Menard, Innocent Valea, Madou Tapsoba, Ousmane Badolo, Paul Sondo, Esperance Ouédraogo, Cheick Saïd Compaoré, Rene Kinda, Adama Gansané, Blami Dao, Isidore Yerbanga, Edwige Soulama, David T. Kangoye, Halidou Tinto, Casimir Tarama, Samuel Tchwenko
Přispěvatelé: Centre National de Recherche et de Formation sur le Paludisme [Ouagadougou, Burkina Faso] (CNRFP), U.S. President's Malaria Initiative [Atlanta, GA,], Génétique du paludisme et résistance - Malaria Genetics and Resistance, Institut Pasteur [Paris], INSERM U1201 (U1201), Unité de Biologie des interactions hôte-parasite (U1201), Institut de Recherche en Sciences de la Santé (IRSS), CNRST, National Malaria Control Programme [Ouagadougou, Burkina Faso], Improving Malaria Care [Ouagadougou, Burkina Faso], Jhpiego [Baltimore], The study was funded by the US President’s Malaria Initiative through the Improving Malaria Care Project., Institut Pasteur [Paris] (IP), Biologie des Interactions Hôte-Parasite - Biology of Host-Parasite Interactions, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
Artemether/lumefantrine
Efficacy
Combination therapy
lcsh:RC955-962
Plasmodium falciparum
030231 tropical medicine
Drug Resistance
Antimalarial
lcsh:Infectious and parasitic diseases
law.invention
Antimalarials
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Dihydroartemisinin/piperaquine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
law
Internal medicine
parasitic diseases
medicine
Clinical endpoint
Humans
lcsh:RC109-216
[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology
030212 general & internal medicine
Malaria
Falciparum
Artemether-lumefantrine
Artemisinin
business.industry
Research
Burkina faso
Artemether
Lumefantrine Drug Combination
Infant
medicine.disease
Artemisinins
3. Good health
Clinical trial
Infectious Diseases
Child
Preschool
Quinolines
Female
Parasitology
business
Malaria
Dihydroartemisinin-piperaquine
medicine.drug
Zdroj: Malaria Journal
Malaria Journal, BioMed Central, 2021, 20 (1), pp.48. ⟨10.1186/s12936-021-03585-6⟩
Malaria Journal, Vol 20, Iss 1, Pp 1-12 (2021)
Malaria Journal, 2021, 20 (1), pp.48. ⟨10.1186/s12936-021-03585-6⟩
ISSN: 1475-2875
DOI: 10.1186/s12936-021-03585-6
Popis: Background The World Health Organization recommends regularly assessing the efficacy of artemisinin-based combination therapy (ACT), which is a critical tool in the fight against malaria. This study evaluated the efficacy of two artemisinin-based combinations recommended to treat uncomplicated Plasmodium falciparum malaria in Burkina Faso in three sites: Niangoloko, Nanoro, and Gourcy. Methods This was a two-arm randomized control trial of the efficacy of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Children aged 6–59 months old were monitored for 42 days. The primary outcomes of the study were uncorrected and PCR-corrected efficacies to day 28 for AL and 42 for DP. Molecular markers of resistance to artemisinin derivatives and partner drugs were also analysed. Results Of 720 children enrolled, 672 reached study endpoints at day 28, 333 in the AL arm and 339 in the DP arm. PCR-corrected 28-day per protocol efficacy in the AL arm was 74% (64–83%) in Nanoro, 76% (66–83%) in Gourcy, and 92% (84–96%) in Niangoloko. The PCR-corrected 42-day per protocol efficacy in the DP arm was 84% (75–89%) in Gourcy, 89% (81–94%) in Nanoro, and 97% (92–99%) in Niangoloko. No Pfk13 mutation previously associated with artemisinin-resistance was observed. No statistically significant association was found between treatment outcome and presence of the 86Y mutation in the Pfmdr1 gene. There was also no association observed between treatment outcome and Pfpm2 or Pfmdr1 copy number variation. Conclusion The results of this study indicate evidence of inadequate efficacy of AL at day 28 and DP at day 42 in the same two sites. A change of first-line ACT may be warranted in Burkina Faso. Trial Registry Pan African Clinical Trial Registry Identifier: PACTR201708002499311. Date of registration: 8/3/2017 https://pactr.samrc.ac.za/Search.aspx
Databáze: OpenAIRE
Externí odkaz: