In vivo efficacy of artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated falciparum malaria in children: a multisite, open-label, two-cohort, ... View Full Text


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Article Info

DATE

2014-12

AUTHORS

Abel Nhama, Quique Bassat, Sónia Enosse, Arsenio Nhacolo, Rosália Mutemba, Eva Carvalho, Eva Naueia, Esperança Sevene, Caterina Guinovart, Marian Warsame, Sergi Sanz, Abdul Mussa, Graça Matsinhe, Pedro Alonso, Armindo Tiago, Eusebio Macete

ABSTRACT

BACKGROUND: Mozambique adopted artemisinin-based combination therapy (ACT) for the treatment of uncomplicated Plasmodium falciparum malaria in the year 2006, and since 2009 artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) have been proposed as alternative first-line treatments. A multicentre study was conducted in five sites across the country to assess the in vivo efficacy and tolerability of these two drugs. METHODS: Children aged six to 59 months with uncomplicated malaria were recruited between June 2011 and January 2012 in five sites across Mozambique (Montepuez, Dondo, Tete, Chokwe, and Manhiça), and treated with AL or ASAQ in a non-randomized study. Follow-up was organized following standard WHO recommendations for in vivo studies, and included daily visits during the three-day-long supervised treatment course, followed by weekly visits up to day 28. The study primary outcome was the day 28 PCR-corrected early treatment failure (ETF), late clinical failure (LCF), late parasitological failure (LPF), and adequate clinical and parasitological response (ACPR). PCR was performed centrally for all cases of recurrent parasitaemia from day 7 onwards to distinguish recrudescence from re-infection. RESULTS: Four-hundred and thirty-nine (AL cohort; five sites) and 261 (ASAQ cohort, three sites) children were recruited to the study. Day 28 PCR-corrected efficacy for AL was 96.0% (335/339; 95% CI: 93.4-97.8), while for ASAQ it was 99.6% (232/233; 95% CI: 97.6-99.9). The majority of recurring parasitaemia cases throughout follow-up were shown to be re-infections by PCR. Both drugs were well tolerated, with the most frequent adverse event being vomiting (AL 4.5% [20/439]; ASAQ 9.6% [25/261]) and no significant events deemed related to the study drugs. CONCLUSION: This study confirms that both AL and ASAQ remain highly efficacious and well tolerated for the treatment of uncomplicated malaria in Mozambican children. Studies such as these should be replicated regularly in the selected surveillance sentinel sites to continuously monitor the efficacy of these drugs and to rapidly detect any potential signs of declining efficacy to ACT, the mainstay of malaria treatment. More... »

PAGES

309

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1475-2875-13-309

DOI

http://dx.doi.org/10.1186/1475-2875-13-309

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1029508817

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25108397


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Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

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Turtle is a human-readable linked data format.

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RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/1475-2875-13-309'


 

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305 schema:name Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
306 National Institute of Health (INS), Ministry of Health, Maputo, Mozambique
307 rdf:type schema:Organization
308 https://www.grid.ac/institutes/grid.5841.8 schema:alternateName University of Barcelona
309 schema:name Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
310 Department Salut Pública, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
311 rdf:type schema:Organization
 




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