Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial
Abstract Background Malaria control largely depends on availability of highly efficacious drugs, however, over the years, has been threatened by emergence of drug resistance. It is, therefore, important to monitor the impact of recurrent anti-malarial treatment on the long-term efficacy of anti-mala...
Published in: | Malaria Journal |
---|---|
Main Authors: | , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
BMC
2018
|
Subjects: | |
Online Access: | https://doi.org/10.1186/s12936-018-2552-6 https://doaj.org/article/48d3ef27ae164a29b441f2a1eb95d061 |
id |
ftdoajarticles:oai:doaj.org/article:48d3ef27ae164a29b441f2a1eb95d061 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:48d3ef27ae164a29b441f2a1eb95d061 2023-05-15T15:17:23+02:00 Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial Pauline Byakika-Kibwika Patience Nyakato Mohammed Lamorde Agnes N. Kiragga 2018-10-01T00:00:00Z https://doi.org/10.1186/s12936-018-2552-6 https://doaj.org/article/48d3ef27ae164a29b441f2a1eb95d061 EN eng BMC http://link.springer.com/article/10.1186/s12936-018-2552-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2552-6 1475-2875 https://doaj.org/article/48d3ef27ae164a29b441f2a1eb95d061 Malaria Journal, Vol 17, Iss 1, Pp 1-6 (2018) Artesunate ACT Malaria Parasite clearance Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2018 ftdoajarticles https://doi.org/10.1186/s12936-018-2552-6 2022-12-31T12:00:59Z Abstract Background Malaria control largely depends on availability of highly efficacious drugs, however, over the years, has been threatened by emergence of drug resistance. It is, therefore, important to monitor the impact of recurrent anti-malarial treatment on the long-term efficacy of anti-malarial regimens, especially in sub-Saharan African countries with high malaria transmission. Evaluation of parasite clearance following treatment of severe malaria with intravenous artesunate among patients in Eastern Uganda, was performed, as a contribution to monitoring anti-malarial effectiveness. Methods Parasite clearance data obtained from a clinical trial whose objective was to evaluate the 42-day parasitological treatment outcomes and safety following treatment of severe malaria with intravenous artesunate plus artemisinin-based combination therapy among patients attending Tororo District Hospital in Eastern Uganda, were analysed. Serial blood smears were performed at 0, 1, 2, 4, 6, 8, 10, 12, 16, 20, 24 h, followed by 6-hourly blood smears post start of treatment until 6 h post the first negative blood smear when parasite clearance was achieved. Study endpoints were; parasite clearance half-life (the time required for parasitaemia to decrease by 50% based on the linear portion of the parasite clearance slope) and parasite clearance time (time required for complete clearance of initial parasitaemia). Results One hundred and fifty participants with severe malaria were enrolled. All participants were treated with intravenous artesunate. All study participants tolerated artesunate well with rapid recovery from symptoms and ability to take oral mediation within 24 h. No immediate adverse events were recorded. The median (IQR) number of days to complete parasite clearance was of 2 (1–2). The median (IQR) time to clear 50% and 99% parasites was 4.8 (3.61–7.10) and 17.55 (14.66–20.66) h, respectively. The median estimated clearance rate constant per hour was 0.32. The median (IQR) slope half-life was 2.15 (1.64, 2.61) ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 17 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Artesunate ACT Malaria Parasite clearance Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Artesunate ACT Malaria Parasite clearance Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Pauline Byakika-Kibwika Patience Nyakato Mohammed Lamorde Agnes N. Kiragga Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial |
topic_facet |
Artesunate ACT Malaria Parasite clearance Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Malaria control largely depends on availability of highly efficacious drugs, however, over the years, has been threatened by emergence of drug resistance. It is, therefore, important to monitor the impact of recurrent anti-malarial treatment on the long-term efficacy of anti-malarial regimens, especially in sub-Saharan African countries with high malaria transmission. Evaluation of parasite clearance following treatment of severe malaria with intravenous artesunate among patients in Eastern Uganda, was performed, as a contribution to monitoring anti-malarial effectiveness. Methods Parasite clearance data obtained from a clinical trial whose objective was to evaluate the 42-day parasitological treatment outcomes and safety following treatment of severe malaria with intravenous artesunate plus artemisinin-based combination therapy among patients attending Tororo District Hospital in Eastern Uganda, were analysed. Serial blood smears were performed at 0, 1, 2, 4, 6, 8, 10, 12, 16, 20, 24 h, followed by 6-hourly blood smears post start of treatment until 6 h post the first negative blood smear when parasite clearance was achieved. Study endpoints were; parasite clearance half-life (the time required for parasitaemia to decrease by 50% based on the linear portion of the parasite clearance slope) and parasite clearance time (time required for complete clearance of initial parasitaemia). Results One hundred and fifty participants with severe malaria were enrolled. All participants were treated with intravenous artesunate. All study participants tolerated artesunate well with rapid recovery from symptoms and ability to take oral mediation within 24 h. No immediate adverse events were recorded. The median (IQR) number of days to complete parasite clearance was of 2 (1–2). The median (IQR) time to clear 50% and 99% parasites was 4.8 (3.61–7.10) and 17.55 (14.66–20.66) h, respectively. The median estimated clearance rate constant per hour was 0.32. The median (IQR) slope half-life was 2.15 (1.64, 2.61) ... |
format |
Article in Journal/Newspaper |
author |
Pauline Byakika-Kibwika Patience Nyakato Mohammed Lamorde Agnes N. Kiragga |
author_facet |
Pauline Byakika-Kibwika Patience Nyakato Mohammed Lamorde Agnes N. Kiragga |
author_sort |
Pauline Byakika-Kibwika |
title |
Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial |
title_short |
Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial |
title_full |
Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial |
title_fullStr |
Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial |
title_full_unstemmed |
Assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in Ugandan children enrolled in a randomized controlled clinical trial |
title_sort |
assessment of parasite clearance following treatment of severe malaria with intravenous artesunate in ugandan children enrolled in a randomized controlled clinical trial |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s12936-018-2552-6 https://doaj.org/article/48d3ef27ae164a29b441f2a1eb95d061 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 17, Iss 1, Pp 1-6 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s12936-018-2552-6 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2552-6 1475-2875 https://doaj.org/article/48d3ef27ae164a29b441f2a1eb95d061 |
op_doi |
https://doi.org/10.1186/s12936-018-2552-6 |
container_title |
Malaria Journal |
container_volume |
17 |
container_issue |
1 |
_version_ |
1766347628873777152 |