Efficacy of artesunate–amodiaquine in the treatment of falciparum uncomplicated malaria in Madagascar View Full Text


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Article Info

DATE

2018-12

AUTHORS

Oméga Raobela, Valérie Andriantsoanirina, David Gael Rajaonera, Tovonahary Angelo Rakotomanga, Stéphane Rabearimanana, Fanomezantsoa Ralinoro, Didier Ménard, Arsène Ratsimbasoa

ABSTRACT

BACKGROUND: Since 2006, the artemisinin-based combination therapy (ACT) are recommended to treat uncomplicated malaria including non Plasmodium falciparum malaria in Madagascar. Artesunate-amodiaquine (ASAQ) and artemether-lumefantrine are the first- and second-line treatment in uncomplicated falciparum malaria, respectively. No clinical drug efficacy study has been published since 2009 to assess the efficacy of these two artemisinin-based combinations in Madagascar, although the incidence of malaria cases has increased from 2010 to 2016. In this context, new data about the efficacy of the drug combinations currently used to treat malaria are needed. METHODS: Therapeutic efficacy studies evaluating the efficacy of ASAQ were conducted in 2012, 2013 and 2016 among falciparum malaria-infected patients aged between 6 months and 56 years, in health centres in 6 sites representing different epidemiological patterns. The 2009 World Health Organization protocol for monitoring anti-malarial drug efficacy was followed. RESULTS: A total of 348 enrolled patients met the inclusion criteria including 108 patients in 2012 (n = 64 for Matanga, n = 44 for Ampasipotsy), 123 patients in 2013 (n = 63 for Ankazomborona, n = 60 for Anjoma Ramartina) and 117 patients in 2016 (n = 67 for Tsaratanana, n = 50 for Antanimbary). The overall cumulative PCR-corrected day 28 cure rate was 99.70% (95% IC 98.30-99.95). No significant difference in cure rates was observed overtime: 99.02% (95% IC 94.65-99.83) in 2012; 100% (95% IC 96.8-100) in 2013 and 100% (95% IC 96.65-100) in 2016. CONCLUSION: The ASAQ combination remains highly effective for the treatment of uncomplicated falciparum malaria in Madagascar. More... »

PAGES

284

References to SciGraph publications

  • 2017-12. Therapeutic efficacy and artemisinin resistance in northern Myanmar: evidence from in vivo and molecular marker studies in MALARIA JOURNAL
  • 2014-12. Efficacy of artesunate-amodiaquine for the treatment of acute uncomplicated falciparum malaria in southern Mauritania in MALARIA JOURNAL
  • 2012-12. Efficacy of fixed-dose combination artesunate-amodiaquine versus artemether-lumefantrine for uncomplicated childhood Plasmodium falciparum malaria in Democratic Republic of Congo: a randomized non-inferiority trial in MALARIA JOURNAL
  • 2008-12. Assessment of the efficacy of antimalarial drugs recommended by the National Malaria Control Programme in Madagascar: Up-dated baseline data from randomized and multi-site clinical trials in MALARIA JOURNAL
  • 2016-12. Therapeutic efficacy trial of artemisinin-based combination therapy for the treatment of uncomplicated malaria and investigation of mutations in k13 propeller domain in Togo, 2012–2013 in MALARIA JOURNAL
  • 2009-12. Randomized, multicentre assessment of the efficacy and safety of ASAQ – a fixed-dose artesunate-amodiaquine combination therapy in the treatment of uncomplicated Plasmodium falciparum malaria in MALARIA JOURNAL
  • 1995-10-26. Detection and Identification of the Four Malaria Parasite Species Infecting Humans by PCR Amplification in SPECIES DIAGNOSTICS PROTOCOLS
  • 2014-12. In vivo efficacy of artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated falciparum malaria in children: a multisite, open-label, two-cohort, clinical trial in Mozambique in MALARIA JOURNAL
  • 2012-12. The efficacy and tolerability of artemisinin-piperaquine (Artequick®) versus artesunate-amodiaquine (Coarsucam™) for the treatment of uncomplicated Plasmodium falciparum malaria in south-central Vietnam in MALARIA JOURNAL
  • 2009-12. Efficacy of artesunate-amodiaquine for treating uncomplicated falciparum malaria in sub-Saharan Africa: a multi-centre analysis in MALARIA JOURNAL
  • 2015-12. Efficacy of artemether–lumefantrine therapy for the treatment of uncomplicated Plasmodium falciparum malaria in Southwestern Ethiopia in MALARIA JOURNAL
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    PUBMED

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