Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan
Abstract Background First-line schizontocidal treatment for uncomplicated malaria in the Republic of the Sudan is artesunate (total dose 12 mg/kg) plus Sulphadoxine/pyrimethamine (25/1.25 mg/kg) (AS/SP). Patients with Plasmodium vivax are also treated with 14 days primaquine (total dose 3.5 mg/kg) (...
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ftdoajarticles:oai:doaj.org/article:4753e3c233294c71807835361fbf731b 2023-05-15T15:17:46+02:00 Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan Muzamil Mahdi Abdel Hamid Kamala Thriemer Maha E. Elobied Nouh S. Mahgoub Salah A. Boshara Hassan M. H. Elsafi Suhaib A. Gumaa Tassneem Hamid Hanadi Abdelbagi Hamid M. Basheir Jutta Marfurt Ingrid Chen Roly Gosling Ric N. Price Benedikt Ley 2018-03-01T00:00:00Z https://doi.org/10.1186/s12936-018-2266-9 https://doaj.org/article/4753e3c233294c71807835361fbf731b EN eng BMC http://link.springer.com/article/10.1186/s12936-018-2266-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2266-9 1475-2875 https://doaj.org/article/4753e3c233294c71807835361fbf731b Malaria Journal, Vol 17, Iss 1, Pp 1-14 (2018) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2018 ftdoajarticles https://doi.org/10.1186/s12936-018-2266-9 2022-12-31T09:22:08Z Abstract Background First-line schizontocidal treatment for uncomplicated malaria in the Republic of the Sudan is artesunate (total dose 12 mg/kg) plus Sulphadoxine/pyrimethamine (25/1.25 mg/kg) (AS/SP). Patients with Plasmodium vivax are also treated with 14 days primaquine (total dose 3.5 mg/kg) (PQ). The aim of this study was to assess the efficacy of the national policy. Methods Patients above 1 year, with microscopy-confirmed, Plasmodium falciparum and/or P. vivax malaria were treated with AS/SP. Patients with P. falciparum were randomized to no primaquine (Pf-noPQ) or a single 0.25 mg/kg dose of PQ (Pf-PQ1). Patients with P. vivax received 14 days unsupervised 3.5 mg/kg PQ (Pv-PQ14) on day 2 or at the end of follow up (Pv-noPQ). Primary endpoint was the risk of recurrent parasitaemia at day 42. G6PD activity was measured by spectrophotometry and the Accessbio Biosensor™. Results 231 patients with P. falciparum (74.8%), 77 (24.9%) with P. vivax and 1 (0.3%) patient with mixed infection were enrolled. The PCR corrected cumulative risk of recurrent parasitaemia on day 42 was 3.8% (95% CI 1.2–11.2%) in the Pf-noPQ arm compared to 0.9% (95% CI 0.1–6.0%) in the Pf-PQ1 arm; (HR = 0.25 [95% CI 0.03–2.38], p = 0.189). The corresponding risks of recurrence were 13.4% (95% CI 5.2–31.9%) in the Pv-noPQ arm and 5.3% (95% CI 1.3–19.4%) in the Pv-PQ14 arm (HR 0.36 [95% CI 0.1–2.0], p = 0.212). Two (0.9%) patients had G6PD enzyme activity below 10%, 19 (8.9%) patients below 60% of the adjusted male median. Correlation between spectrophotometry and Biosensor™ was low (rs = 0.330, p < 0.001). Conclusion AS/SP remains effective for the treatment of P. falciparum and P. vivax. The addition of PQ reduced the risk of recurrent P. falciparum and P. vivax by day 42, although this did not reach statistical significance. The version of the Biosensor™ assessed is not suitable for routine use. Trial registration https://clinicaltrials.gov/ct2/show/NCT02592408 Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 17 1 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Muzamil Mahdi Abdel Hamid Kamala Thriemer Maha E. Elobied Nouh S. Mahgoub Salah A. Boshara Hassan M. H. Elsafi Suhaib A. Gumaa Tassneem Hamid Hanadi Abdelbagi Hamid M. Basheir Jutta Marfurt Ingrid Chen Roly Gosling Ric N. Price Benedikt Ley Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background First-line schizontocidal treatment for uncomplicated malaria in the Republic of the Sudan is artesunate (total dose 12 mg/kg) plus Sulphadoxine/pyrimethamine (25/1.25 mg/kg) (AS/SP). Patients with Plasmodium vivax are also treated with 14 days primaquine (total dose 3.5 mg/kg) (PQ). The aim of this study was to assess the efficacy of the national policy. Methods Patients above 1 year, with microscopy-confirmed, Plasmodium falciparum and/or P. vivax malaria were treated with AS/SP. Patients with P. falciparum were randomized to no primaquine (Pf-noPQ) or a single 0.25 mg/kg dose of PQ (Pf-PQ1). Patients with P. vivax received 14 days unsupervised 3.5 mg/kg PQ (Pv-PQ14) on day 2 or at the end of follow up (Pv-noPQ). Primary endpoint was the risk of recurrent parasitaemia at day 42. G6PD activity was measured by spectrophotometry and the Accessbio Biosensor™. Results 231 patients with P. falciparum (74.8%), 77 (24.9%) with P. vivax and 1 (0.3%) patient with mixed infection were enrolled. The PCR corrected cumulative risk of recurrent parasitaemia on day 42 was 3.8% (95% CI 1.2–11.2%) in the Pf-noPQ arm compared to 0.9% (95% CI 0.1–6.0%) in the Pf-PQ1 arm; (HR = 0.25 [95% CI 0.03–2.38], p = 0.189). The corresponding risks of recurrence were 13.4% (95% CI 5.2–31.9%) in the Pv-noPQ arm and 5.3% (95% CI 1.3–19.4%) in the Pv-PQ14 arm (HR 0.36 [95% CI 0.1–2.0], p = 0.212). Two (0.9%) patients had G6PD enzyme activity below 10%, 19 (8.9%) patients below 60% of the adjusted male median. Correlation between spectrophotometry and Biosensor™ was low (rs = 0.330, p < 0.001). Conclusion AS/SP remains effective for the treatment of P. falciparum and P. vivax. The addition of PQ reduced the risk of recurrent P. falciparum and P. vivax by day 42, although this did not reach statistical significance. The version of the Biosensor™ assessed is not suitable for routine use. Trial registration https://clinicaltrials.gov/ct2/show/NCT02592408 |
format |
Article in Journal/Newspaper |
author |
Muzamil Mahdi Abdel Hamid Kamala Thriemer Maha E. Elobied Nouh S. Mahgoub Salah A. Boshara Hassan M. H. Elsafi Suhaib A. Gumaa Tassneem Hamid Hanadi Abdelbagi Hamid M. Basheir Jutta Marfurt Ingrid Chen Roly Gosling Ric N. Price Benedikt Ley |
author_facet |
Muzamil Mahdi Abdel Hamid Kamala Thriemer Maha E. Elobied Nouh S. Mahgoub Salah A. Boshara Hassan M. H. Elsafi Suhaib A. Gumaa Tassneem Hamid Hanadi Abdelbagi Hamid M. Basheir Jutta Marfurt Ingrid Chen Roly Gosling Ric N. Price Benedikt Ley |
author_sort |
Muzamil Mahdi Abdel Hamid |
title |
Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan |
title_short |
Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan |
title_full |
Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan |
title_fullStr |
Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan |
title_full_unstemmed |
Low risk of recurrence following artesunate–Sulphadoxine–pyrimethamine plus primaquine for uncomplicated Plasmodium falciparum and Plasmodium vivax infections in the Republic of the Sudan |
title_sort |
low risk of recurrence following artesunate–sulphadoxine–pyrimethamine plus primaquine for uncomplicated plasmodium falciparum and plasmodium vivax infections in the republic of the sudan |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s12936-018-2266-9 https://doaj.org/article/4753e3c233294c71807835361fbf731b |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 17, Iss 1, Pp 1-14 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s12936-018-2266-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2266-9 1475-2875 https://doaj.org/article/4753e3c233294c71807835361fbf731b |
op_doi |
https://doi.org/10.1186/s12936-018-2266-9 |
container_title |
Malaria Journal |
container_volume |
17 |
container_issue |
1 |
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1766347996941778944 |