Evaluation of the efficacy and safety of three 2-drug combinations for the treatment of uncomplicated Plasmodium falciparum malaria in Senegal: artesunate-amodiaquine, dihydroartemisinin-piperaquine, and artemether-lumefantrine
| Autor: | Doudou Sow, R. Tine, M. Ndiaye, Jean Louis Ndiaye, Mbaye Pene, Mamadou S. Ba, Gaye O, A. C. Lo, Babacar Faye, Y. Dieng, K Sylla, Annie Abiola, A. Seck |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Artemether/lumefantrine Adolescent Population Pharmacology Antimalarials Young Adult Dihydroartemisinin/piperaquine Internal medicine parasitic diseases medicine Humans Prospective Studies Malaria Falciparum Artemisinin Child education Fluorenes education.field_of_study biology business.industry Artemether Lumefantrine Drug Combination Artesunate/amodiaquine Public Health Environmental and Occupational Health Amodiaquine Plasmodium falciparum Middle Aged medicine.disease biology.organism_classification Artemisinins Senegal Drug Combinations Treatment Outcome Infectious Diseases Tolerability Ethanolamines Child Preschool Quinolines Female business Malaria medicine.drug |
| Zdroj: | Médecine et Santé Tropicales. 26:45-50 |
| ISSN: | 2261-2211 2261-3684 |
| DOI: | 10.1684/mst.2015.0524 |
| Popis: | BACKGROUND Since 2006, artemisinin-based combination therapies (ACT) have been used to treat uncomplicated Plasmodium falciparum malaria in Senegal, as recommended by WHO. Recently, decreased parasite clearance with artemisinin derivatives has been reported in Cambodia and Thailand. The effectiveness of artemisinin derivatives in Africa must be monitored. This study was conducted to evaluate the efficacy and the tolerability of three ACT widely used in Senegal. METHODS From October 2010 to February 2011, a descriptive and analytical sequential study was conducted in adults and children to evaluate these three combinations: artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), and dihydroartemisinin-piperaquine (DHAPQ). The study took place at the health posts of Deggo and Pikine and the health center of Guediawaye, in the suburbs of Dakar. The primary endpoint was the PCR-corrected adequate clinical and parasitological response (ACPR) at day 28 (D28); the secondary endpoints included ACPR at D42, clearance times for parasites, fever, and gametocytes, and the incidence of adverse events. RESULTS The study included 393 patients: 139 in the AL group, 130 in the ASAQ group, and 124 in the DHAPQ group. In the intent-to-treat population, PCR-corrected ACPR at day 28 was 92.8% in the AL, 89.2% in the ASAQ, and 91.1% in the DHAPQ (p = 0.58) groups, and in the per-protocol population, 98.4%, 98.3%, and 100% respectively (p = 0.39). At D42, ACPR was 99.2% in the AL, and 99.1% in each of the ASAQ and DHAPQ arms (p = 1). No early therapeutic failure (ETF) was observed. The combinations were well tolerated, with no serious adverse events reported during the follow-up period. CONCLUSION These combinations are still effective and well-tolerated. Continued monitoring is nonetheless essential to detect early artemisinin resistance in Africa. |
| Databáze: | OpenAIRE |
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