2024-03-28T12:31:27Zhttp://repisalud.isciii.es/oai/requestoai:repisalud.isciii.es:20.500.12105/139452023-11-07T09:10:41Zcom_20.500.12105_2074com_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_2075
Repisalud
author
Riloha Rivas, Matilde
author
Warsame, Marian
author
Mbá Andeme, Ramona
author
Nsue Esidang, Salomón
author
Ncogo, Policarpo Ricardo
author
Phiri, Wonder Philip
author
Oki Eburi, Consuelo
author
Edú Maye, Corona Eyang
author
Menard, Didier
author
Legrand, Eric
author
Berzosa, Pedro
author
Garcia, Luz
author
Lao Seoane, Angela Katherine
author
Ntabangana, Spes Caritas
author
Ringwald, Pascal
funder
University of Gothenburg (Suecia)
funder
Bill & Melinda Gates Foundation
funder
World Health Organization (WHO/OMS)
funder
Agence Nationale de la Recherche (Francia)
funder
Laboratoire d’Expertise Clinique Espagne
2022-04-07T09:47:29Z
2022-04-07T09:47:29Z
2021-06-22
Malar J. 2021;20(1):275
http://hdl.handle.net/20.500.12105/13945
34158055
10.1186/s12936-021-03807-x
1475-2875
Malaria Journal
Background: Artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) are the currently recommended first- and second-line therapies for uncomplicated Plasmodium falciparum infections in Equatorial Guinea. This study was designed to evaluate the efficacy of these artemisinin-based combinations and detect mutations in P. falciparum kelch13-propeller domain gene (Pfkelch13). Methods: A single-arm prospective study evaluating the efficacy of ASAQ and AL at three sites: Malabo, Bata and Ebebiyin was conducted between August 2017 and July 2018. Febrile children aged six months to 10 years with confirmed uncomplicated P. falciparum infection and other inclusion criteria were sequentially enrolled first in ASAQ and then in AL at each site, and followed up for 28 days. Clinical and parasitological parameters were assessed. The primary endpoint was PCR-adjusted adequate clinical and parasitological response (ACPR). Samples on day-0 were analysed for mutations in Pfkelch13 gene. Results: A total 264 and 226 patients were enrolled in the ASAQ and AL treatment groups, respectively. Based on per-protocol analysis, PCR-adjusted cure rates of 98.6% to 100% and 92.4% to 100% were observed in patients treated with ASAQ and AL, respectively. All study children in both treatment groups were free of parasitaemia by day-3. Of the 476 samples with interpretable results, only three samples carried non-synonymous Pfkelch13 mutations (E433D and A578S), and none of them is the known markers associated with artemisinin resistance. Conclusion: The study confirmed high efficacy of ASAQ and AL for the treatment of uncomplicated falciparum infections as well as the absence of delayed parasite clearance and Pfkelch13 mutations associated with artemisinin resistance. Continued monitoring of the efficacy of these artemisinin-based combinations, at least every two years, along with molecular markers associated with artemisinin and partner drug resistance is imperative to inform national malaria treatment policy and detect resistant parasites early. Trial registration ACTRN12617000456358, Registered 28 March 2017; http://www.anzctr.org.au/trial/MyTrial.aspx.
eng
Artemether–lumefantrine
Artesunate-amodiaquine
Efficacy
Equatorial Guinea
Plasmodium falciparum
Therapeutic efficacy of artesunate-amodiaquine and artemether-lumefantrine and polymorphism in Plasmodium falciparum kelch13-propeller gene in Equatorial Guinea
journal article
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URL
https://repisalud.isciii.es/bitstream/20.500.12105/13945/1/TherapeuticEfficacyOfArtesunate_2021.pdf
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https://repisalud.isciii.es/bitstream/20.500.12105/13945/4/TherapeuticEfficacyOfArtesunate_2021.pdf.txt
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TherapeuticEfficacyOfArtesunate_2021.pdf.txt