| Title |
Efficacy and safety of artemether–lumefantrine, artesunate–amodiaquine, and dihydroartemisinin–piperaquine for the treatment of uncomplicated Plasmodium falciparum malaria in three provinces in Angola, 2017
|
|---|---|
| Published in |
Malaria Journal, April 2018
|
| DOI | 10.1186/s12936-018-2290-9 |
| Pubmed ID | |
| Authors |
Elizabeth Davlantes, Pedro Rafael Dimbu, Carolina Miguel Ferreira, Maria Florinda Joao, Dilunvuidi Pode, Jacinto Félix, Edgar Sanhangala, Benjamin Nieto Andrade, Samaly dos Santos Souza, Eldin Talundzic, Venkatachalam Udhayakumar, Chantelle Owens, Eliane Mbounga, Lubbe Wiesner, Eric S. Halsey, José Franco Martins, Filomeno Fortes, Mateusz M. Plucinski |
| Abstract |
The Angolan government recommends three artemisinin-based combinations for the treatment of uncomplicated Plasmodium falciparum malaria: artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), and dihydroartemisinin-piperaquine (DP). Due to the threat of emerging anti-malarial drug resistance, it is important to periodically monitor the efficacy of artemisinin-based combination therapy (ACT). This study evaluated these medications' therapeutic efficacy in Benguela, Lunda Sul, and Zaire Provinces. Enrollment occurred between March and July 2017. Study participants were children with P. falciparum monoinfection from each provincial capital. Participants received a 3-day course of a quality-assured artemisinin-based combination and were monitored for 28 (AL and ASAQ arms) or 42 days (DP arm). Each ACT was assessed in two provinces. The primary study endpoints were: (1) follow-up without complications and (2) failure to respond to treatment or development of recurrent P. falciparum infection. Parasites from each patient experiencing recurrent infection were genotyped to differentiate new infection from recrudescence of persistent parasitaemia. These parasites were also analysed for molecular markers associated with ACT resistance. Of 608 children enrolled in the study, 540 (89%) reached a primary study endpoint. Parasitaemia was cleared within 3 days of medication administration in all participants, and no early treatment failures were observed. After exclusion of reinfections, the corrected efficacy of AL was 96% (91-100%, 95% confidence interval) in Zaire and 97% (93-100%) in Lunda Sul. The corrected efficacy of ASAQ was 100% (97-100%) in Benguela and 93% (88-99%) in Zaire. The corrected efficacy of DP was 100% (96-100%) in Benguela and 100% in Lunda Sul. No mutations associated with artemisinin resistance were identified in the pfk13 gene in the 38 cases of recurrent P. falciparum infection. All 33 treatment failures in the AL and ASAQ arms carried pfmdr1 or pfcrt mutations associated with lumefantrine and amodiaquine resistance, respectively, on day of failure. AL, ASAQ, and DP continue to be efficacious against P. falciparum malaria in these provinces of Angola. Rapid parasite clearance and the absence of genetic evidence of artemisinin resistance are consistent with full susceptibility to artemisinin derivatives. Periodic monitoring of in vivo drug efficacy remains a priority routine activity for Angola. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
| Members of the public | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 99 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 99 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 22 | 22% |
| Student > Ph. D. Student | 13 | 13% |
| Researcher | 11 | 11% |
| Student > Bachelor | 6 | 6% |
| Lecturer | 4 | 4% |
| Other | 13 | 13% |
| Unknown | 30 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 17% |
| Biochemistry, Genetics and Molecular Biology | 14 | 14% |
| Agricultural and Biological Sciences | 9 | 9% |
| Pharmacology, Toxicology and Pharmaceutical Science | 7 | 7% |
| Immunology and Microbiology | 4 | 4% |
| Other | 15 | 15% |
| Unknown | 33 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 250. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 February 2022.
All research outputs
#127,161
of 23,322,258 outputs
Outputs from Malaria Journal
#14
of 5,657 outputs
Outputs of similar age
#3,369
of 329,915 outputs
Outputs of similar age from Malaria Journal
#1
of 124 outputs
Altmetric has tracked 23,322,258 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
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