Plasmodium falciparum clearance in clinical studies of artesunate-amodiaquine and comparator treatments in sub-Saharan Africa, 1999–2009
Citations
115 citations
Cites background from "Plasmodium falciparum clearance in ..."
...Second, as delayed clearance of parasites after therapy is uncommon and associated with high baseline parasitemia in Uganda, persistent parasitemia 2 days after the onset of therapy is likely not a reliable indicator of resistance [6,8]....
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36 citations
Cites background from "Plasmodium falciparum clearance in ..."
...However, ACTs remain highly efficacious in subSaharan Africa (SSA) with fast clearance half-lives (Ashley et al., 2014; Zwang et al., 2014)....
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Cites background from "Plasmodium falciparum clearance in ..."
...falciparum resistance to artemisinin derivatives in Southeast Asia (where it was introduced for the first time in the mid-1990s), but so far it has not been detected in Africa (13)....
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References
307 citations
"Plasmodium falciparum clearance in ..." refers background or methods in this paper
...Predicted time of parasite clearance The number of patients included in RCT at 17 sites with complete parasitaemia record (every 24 hours from Day 0 to Day 3 plus Day 7) was 4,848 of whom 2,355 were treated with ASAQ and 2,493 with a comparator drug....
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...Consecutive parasite slide results (Day 0, Day 1, Day 2, Day 3, Day 7) were available at 18 sites from five randomized controlled trials (RCT) [17-19,26,27]....
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...Using multivariate logistic regression with random effect on site and controlling for treatment, the risk factors for a patient to remain positive on Day 2 were higher parasitaemia before treatment (AOR 2.12, 95% CI 1.91-2.35, p = 0.001) and anaemia (AOR 1.22, 95% CI 1.07-1.38, p = 0.001); no significant difference in the risk of being parasitaemic on Day 2 was detected in RCT comparing ASAQ to other ACT: AL (p = 0.245), DP (p = 0.762), AS + SP (p = 0.291), whereas patients treated with non-ACT were at higher risk: AQ+ SP (AOR 14.53, 95% CI 11.36-18.59, p = 0.001), CQ + SP (AOR 20.10, 95% CI 15.07-26.82, p = 0.001), or AQ (AOR 21.63, 95% CI 12.73-36.75, p = 0.001)....
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...Out of the 27 studies included (conducted between 1999 and 2009), three were multi-country studies [17-19], two studies compared ASAQ fixed and loose combination [20-22] and three studies were non-comparative (in Sierra Leone [23] and Senegal [24,25])....
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290 citations
"Plasmodium falciparum clearance in ..." refers background in this paper
...While ASAQ is generally effective, the decreasing efficacy of AQ single-agent treatment have been reported in some sub-Saharan African settings [14,15]....
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279 citations
"Plasmodium falciparum clearance in ..." refers background in this paper
...Artemisinin tolerance/resistance manifests itself with slower parasite clearance, while ACT remain generally effective both clinically and parasitologically [1-4]....
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Additional excerpts
...An in vitro assay (Ring Stage Assay) has also focused on the very early phases of the ring-stage parasite [7]....
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254 citations
"Plasmodium falciparum clearance in ..." refers background in this paper
...Between parasite clearance estimators [9] and Day 3 persistency [10], simple estimations of PCT based on daily sampling may add elements to facilitate comparisons and detection of trends....
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...However, as of today, in the clinic as well as in the field the parasite clearance time (PCT) and its related clinical phenotype (delayed PCT) remain the best practical surrogates of artemisinin in vivo resistance [8]; the problem is that the frequent sampling (every six or eight hours) required to measure PCT accurately and to estimate the parasite clearance half-life [9] is practically difficult even in research settings....
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