Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018
Abstract Background Since 2005, artemisinin-based combination therapy (ACT) has been recommended to treat uncomplicated falciparum malaria in Madagascar. Artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) are the first- and second-line treatments, respectively. A therapeutic efficacy stu...
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ftdoajarticles:oai:doaj.org/article:df32110b281d46a280c7dd012b62afec 2023-05-15T15:17:18+02:00 Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018 Catherine M. Dentinger Tovonahary Angelo Rakotomanga Antsa Rakotondrandriana Arinomenjanahary Rakotoarisoa Marie Ange Rason Leah F. Moriarty Laura C. Steinhardt Laurent Kapesa Jocelyn Razafindrakoto Samaly S. Svigel Naomi W. Lucchi Venkatachalam Udhayakumar Eric S. Halsey C. Arsène Ratsimbasoa 2021-11-01T00:00:00Z https://doi.org/10.1186/s12936-021-03935-4 https://doaj.org/article/df32110b281d46a280c7dd012b62afec EN eng BMC https://doi.org/10.1186/s12936-021-03935-4 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03935-4 1475-2875 https://doaj.org/article/df32110b281d46a280c7dd012b62afec Malaria Journal, Vol 20, Iss 1, Pp 1-11 (2021) Madagascar Anti-malarial Artemisinin-based combination therapy Resistance Efficacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-03935-4 2022-12-31T11:55:21Z Abstract Background Since 2005, artemisinin-based combination therapy (ACT) has been recommended to treat uncomplicated falciparum malaria in Madagascar. Artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) are the first- and second-line treatments, respectively. A therapeutic efficacy study was conducted to assess ACT efficacy and molecular markers of anti-malarial resistance. Methods Children aged six months to 14 years with uncomplicated falciparum malaria and a parasitaemia of 1000–100,000 parasites/µl determined by microscopy were enrolled from May–September 2018 in a 28-day in vivo trial using the 2009 World Health Organization protocol for monitoring anti-malarial efficacy. Participants from two communes, Ankazomborona (tropical, northwest) and Matanga (equatorial, southeast), were randomly assigned to ASAQ or AL arms at their respective sites. PCR correction was achieved by genotyping seven neutral microsatellites in paired pre- and post-treatment samples. Genotyping assays for molecular markers of resistance in the pfk13, pfcrt and pfmdr1 genes were conducted. Results Of 344 patients enrolled, 167/172 (97%) receiving ASAQ and 168/172 (98%) receiving AL completed the study. For ASAQ, the day-28 cumulative PCR-uncorrected efficacy was 100% (95% CI 100–100) and 95% (95% CI 91–100) for Ankazomborona and Matanga, respectively; for AL, it was 99% (95% CI 97–100) in Ankazomborona and 83% (95% CI 76–92) in Matanga. The day-28 cumulative PCR-corrected efficacy for ASAQ was 100% (95% CI 100–100) and 98% (95% CI 95–100) for Ankazomborona and Matanga, respectively; for AL, it was 100% (95% CI 99–100) in Ankazomborona and 95% (95% CI 91–100) in Matanga. Of 83 successfully sequenced samples for pfk13, no mutation associated with artemisinin resistance was observed. A majority of successfully sequenced samples for pfmdr1 carried either the NFD or NYD haplotypes corresponding to codons 86, 184 and 1246. Of 82 successfully sequenced samples for pfcrt, all were wild type at codons 72–76. Conclusion ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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Madagascar Anti-malarial Artemisinin-based combination therapy Resistance Efficacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Madagascar Anti-malarial Artemisinin-based combination therapy Resistance Efficacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Catherine M. Dentinger Tovonahary Angelo Rakotomanga Antsa Rakotondrandriana Arinomenjanahary Rakotoarisoa Marie Ange Rason Leah F. Moriarty Laura C. Steinhardt Laurent Kapesa Jocelyn Razafindrakoto Samaly S. Svigel Naomi W. Lucchi Venkatachalam Udhayakumar Eric S. Halsey C. Arsène Ratsimbasoa Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018 |
topic_facet |
Madagascar Anti-malarial Artemisinin-based combination therapy Resistance Efficacy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Since 2005, artemisinin-based combination therapy (ACT) has been recommended to treat uncomplicated falciparum malaria in Madagascar. Artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) are the first- and second-line treatments, respectively. A therapeutic efficacy study was conducted to assess ACT efficacy and molecular markers of anti-malarial resistance. Methods Children aged six months to 14 years with uncomplicated falciparum malaria and a parasitaemia of 1000–100,000 parasites/µl determined by microscopy were enrolled from May–September 2018 in a 28-day in vivo trial using the 2009 World Health Organization protocol for monitoring anti-malarial efficacy. Participants from two communes, Ankazomborona (tropical, northwest) and Matanga (equatorial, southeast), were randomly assigned to ASAQ or AL arms at their respective sites. PCR correction was achieved by genotyping seven neutral microsatellites in paired pre- and post-treatment samples. Genotyping assays for molecular markers of resistance in the pfk13, pfcrt and pfmdr1 genes were conducted. Results Of 344 patients enrolled, 167/172 (97%) receiving ASAQ and 168/172 (98%) receiving AL completed the study. For ASAQ, the day-28 cumulative PCR-uncorrected efficacy was 100% (95% CI 100–100) and 95% (95% CI 91–100) for Ankazomborona and Matanga, respectively; for AL, it was 99% (95% CI 97–100) in Ankazomborona and 83% (95% CI 76–92) in Matanga. The day-28 cumulative PCR-corrected efficacy for ASAQ was 100% (95% CI 100–100) and 98% (95% CI 95–100) for Ankazomborona and Matanga, respectively; for AL, it was 100% (95% CI 99–100) in Ankazomborona and 95% (95% CI 91–100) in Matanga. Of 83 successfully sequenced samples for pfk13, no mutation associated with artemisinin resistance was observed. A majority of successfully sequenced samples for pfmdr1 carried either the NFD or NYD haplotypes corresponding to codons 86, 184 and 1246. Of 82 successfully sequenced samples for pfcrt, all were wild type at codons 72–76. Conclusion ... |
format |
Article in Journal/Newspaper |
author |
Catherine M. Dentinger Tovonahary Angelo Rakotomanga Antsa Rakotondrandriana Arinomenjanahary Rakotoarisoa Marie Ange Rason Leah F. Moriarty Laura C. Steinhardt Laurent Kapesa Jocelyn Razafindrakoto Samaly S. Svigel Naomi W. Lucchi Venkatachalam Udhayakumar Eric S. Halsey C. Arsène Ratsimbasoa |
author_facet |
Catherine M. Dentinger Tovonahary Angelo Rakotomanga Antsa Rakotondrandriana Arinomenjanahary Rakotoarisoa Marie Ange Rason Leah F. Moriarty Laura C. Steinhardt Laurent Kapesa Jocelyn Razafindrakoto Samaly S. Svigel Naomi W. Lucchi Venkatachalam Udhayakumar Eric S. Halsey C. Arsène Ratsimbasoa |
author_sort |
Catherine M. Dentinger |
title |
Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018 |
title_short |
Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018 |
title_full |
Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018 |
title_fullStr |
Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018 |
title_full_unstemmed |
Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018 |
title_sort |
efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated plasmodium falciparum malaria in madagascar, 2018 |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-03935-4 https://doaj.org/article/df32110b281d46a280c7dd012b62afec |
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Arctic |
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Arctic |
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Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-11 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-03935-4 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03935-4 1475-2875 https://doaj.org/article/df32110b281d46a280c7dd012b62afec |
op_doi |
https://doi.org/10.1186/s12936-021-03935-4 |
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Malaria Journal |
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20 |
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