Malaria recrudescence after artemether-lumefantrine treatment in travellers– a hospital-based observational study and literature review
Rattachement africain : nl, Sierra Leone, pt, Afrique du Sud, Gabon, de. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
INTRODUCTION: Artemether-lumefantrine (AL) is an effective drug combination that is used to treat uncomplicated falciparum malaria worldwide including travellers. Although this treatment is regarded as highly effective, recrudescence of falciparum malaria may occur in the weeks after treatment with AL. The occurrence of recrudescence and its potential (risk) factors in travellers remain poorly investigated. METHODS: This retrospective cohort study included falciparum malaria cases treated with AL at a tertiary referral hospital in the Netherlands, between January 1, 2010, and July 1, 2024. The primary outcome was the proportion of recrudescence cases among falciparum malaria cases who completed treatment with AL. Recrudescence was defined as a negative microscopy result for Plasmodium falciparum at least once after AL treatment, followed by a subsequent positive result without intercurrent travel to malaria-endemic areas. Secondary outcomes included the proportion of recrudescence cases that experienced secondary treatment failures (recrudescence after retreatment with AL or other malaria therapies) and factors associated with recrudescence. In addition to our cohort study, we performed a literature review on studies reporting on falciparum recrudescence cases after AL treatment among travellers. RESULTS: Of 391 falciparum malaria cases identified, 270 were treated with AL and thus included in this study. Among these, eight (3%; 95% confidence interval [CI]: 1-6%) recrudescence cases were identified. Diarrhoea was a risk factor for recrudescence in our cohort (unadjusted OR 4.9 95%; CI: 1.14-21.06). In the literature, 19 studies reported on 61 recrudescence cases amongst a total of 1,770 malaria cases (3%). No secondary treatment failures occurred in recrudescence cases treated with AL from our cohort or the literature (0/19), whereas secondary treatment with atovaquone-proguanil failed in 2/28 (7%) of cases. INTERPRETATION: Recrudescence after AL treatment is rare among travellers, and was associated with diarrhoea, which might cause malabsorption. When recrudescence occurs, retreatment with AL is effective.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Malaria recrudescence after artemether-lumefantrine treatment in travellers– a hospital-based observational study and literature review
- Date Crossref
- 07/07/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
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
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Amsterdam Institute for Global Health and Development pays non établi dans la noticeStructure de recherche
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Public Health Service of Amsterdam pays non établi dans la noticeÉtablissement de santé
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Amsterdam institute for Immunology and Infectious Diseases pays non établi dans la noticeÉtablissement de santé
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University of Amsterdam Department of Infectious Diseases pays non établi dans la noticeUniversité ou école supérieure
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Sierra Leone Agricultural Research Institute Sierra Leone (code pays fourni par la source)Structure de recherche
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Amsterdam Neuroscience pays non établi dans la noticeStructure de recherche
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Amsterdam University Medical Centers pays non établi dans la noticeÉtablissement de santé
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Vrije Universiteit Amsterdam pays non établi dans la noticeUniversité ou école supérieure
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University of Lisbon pays non établi dans la noticeUniversité ou école supérieure
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University of Cape Town Institute of Infectious Diseases and Molecular Medicine (IDM) University of Cape Town, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Centre de Recherche Médicales de Lambaréné Gabon (code pays fourni par la source)Structure de recherche
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German Center for Infection Research pays non établi dans la noticeStructure de recherche
Amsterdam Institute for Global Health and Development, Public Health Service of Amsterdam et Amsterdam institute for Immunology and Infectious Diseases, avec 9 autres affiliations. Pays d’affiliation : Sierra Leone, Afrique du Sud, Gabon.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.