Therapeutic efficacy of artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali, 2015–2016
Rattachement africain : Mali, us, Ouganda. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Background The current first-line treatments for uncomplicated malaria recommended by the National Malaria Control Program in Mali are artemether–lumefantrine (AL) and artesunate–amodiaquine (ASAQ). From 2015–2016, we conducted an in vivo study to assess the clinical and parasitological responses to AL and ASAQ in Sélingué, Mali. Methods Children between 6 and 59 months of age with uncomplicated Plasmodium falciparum infection and 2,000–200,000 asexual parasites/µL of blood were enrolled, randomly assigned to either AL or ASAQ, and followed up for 42 days. Uncorrected and PCR-corrected efficacy results at days 28 and 42 were calculated. Known markers of resistance in the Pfk13, Pfmdr1, and Pfcrt genes were assessed using Sanger sequencing. Results A total of 449 patients were enrolled: 225 in the AL group and 224 in the ASAQ group. Uncorrected efficacy at day 28 was 83.4% (95% CI: 78.5–88.4%) in the AL arm and 93.1% (95% CI: 89.7–96.5%) in the ASAQ arm. The per protocol PCR-corrected efficacy at day 28 was 91.0% (86.0–95.9%) in the AL arm and 97.1% (93.6–100%) in the ASAQ arm. ASAQ was significantly (p < 0.05) better than AL for each of the aforementioned efficacy outcomes. No mutations associated with artemisinin resistance were identified in the Pfk13 gene. Overall, for Pfmdr1, the N86 allele and the NFD haplotype were the most common. The NFD haplotype was significantly more prevalent in the post-treatment than in the pre-treatment isolates in the AL arm (p < 0.01) but not in the ASAQ arm. For Pfcrt, the CVIET haplotype was the most common. Conclusions Our findings indicate that both AL and ASAQ remain effective for the treatment of uncomplicated malaria in Sélingué, Mali.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Therapeutic efficacy of artemether-lumefantrine and artesunate-amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali, 2015–2016
- Date Crossref
- 24/09/2020
- Éditeur
- Springer Science and Business Media LLC
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Université des Sciences Bamako, Mali (code pays fourni par la source)Université ou école supérieure
-
U.S. President's Malaria Initiative pays non établi dans la noticeInstitution
-
RTI International pays non établi dans la noticeOrganisation à but non lucratif
-
Centers for Disease Control and Prevention Ouganda (code pays fourni par la source)Organisme public
-
Medical Care Development International pays non établi dans la noticeOrganisation à but non lucratif
-
Tulane University pays non établi dans la noticeUniversité ou école supérieure
-
University of Science Techniques and Technologies of Bamako, Mali (ville ou établissement reconnu, pays non nommé)Université ou école supérieure
-
Ministry of Health and Public Health pays non établi dans la noticeOrganisme public
-
Ministry of Health and Public Hygiene pays non établi dans la noticeOrganisme public
-
U.S President's Malaria Initiative Bamako, Mali (ville ou établissement reconnu, pays non nommé)Institution
-
Malaria Branch pays non établi dans la noticeInstitution
-
Tulane School of Public Health and Tropical Medicine pays non établi dans la noticeUniversité ou école supérieure
Université des Sciences (Bamako, Mali), U.S. President's Malaria Initiative et RTI International, avec 9 autres affiliations. Pays d’affiliation : Mali, Ouganda.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.