Plasmodium falciparum clearance time in Malawian children with cerebral malaria: a retrospective cohort study

Saidi, Alexuse M; Guenther, Geoffrey; Izem, Rima; Chen, Xiaojun; Seydel, Karl B.; Postels, Douglas G.

doi:10.1186/s12936-021-03947-0

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…But, the recommended blood sampling every 6 hours until two consecutive negative parasite counts is di cult to implement in clinical care activities, as it was the case in this setting. Anyway, P. vivax PCT model is far less documented than the model used for P. falciparum and its relevance may be affected by the heterogeneity of clinical care, laboratory experience, and sample time collection [41]. The last positive parasite count was thus used as a marker of parasite clearance time, identifying of a sub-group of 16 patients with signi cantly delayed parasite clearance.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of dihydroartemisinin-piperaquine plus primaquine treatment on vivax malaria in North Sumatera, Indonesia: a prospective observational study

Pasaribu

BIN

Nasution

et al. 2023

Preprint

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Objectives. Plasmodium vivax malaria treated with dihydroartemisinin-piperaquine (DHA-PPQ) plus primaquine (PQ) in Indonesia remains challenging. Plasmodium falciparum resistance to DHA-PPQ was documented in Asia and it is suspected that this will also be a concern for P. vivax malaria. Thus, it is needed to test the efficacy on P. vivax regularly. Methods. Aprospective observational study was conducted at North Labuhan Batu Regency (North Sumatera, Indonesia). The outcomes were clinical and parasitological efficacy of the 3-day DHA-PPQ plus PQ therapy and the prevalence of pvmdr1, pvk12, and pvpm4 molecular markers of chloroquine and DHA-PPQ resistance. Results. During the 6-months study period, 100 patients were included and four were lost to follow-up. Ninety-six patients were included in the per-protocol analysis. A residual parasitemia was observed for a total of 16 patients: 10 patients on day 7 (10.7%), one patient on day 21 (1.0 %), and five patients on day 28 (5.3%). None of the residual parasitemia based on microscopy was associated with fever or symptoms. None of the molecular markers of ACT resistance was detected among the samples tested. Conclusions. This study did not provide evidence of a decreased efficacy of DHA-PPQ plus PQ regimen against P. vivax, but it highlighted the need for active surveillance of ACT efficacy, as it may be a warning signal before clinical therapeutic failure. A decreased sensitivity of P. vivax in North Sumatera would be an essential threat for Indonesia on its path toward malaria elimination.

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Section: Discussionmentioning

confidence: 99%

Efficacy of dihydroartemisinin-piperaquine plus primaquine treatment on vivax malaria in North Sumatera, Indonesia: a prospective observational study

Pasaribu

BIN

Nasution

et al. 2023

Preprint

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“…Moreover, those results may be affected by the heterogeneity of clinical care, laboratory experience and sample time collection [35]. Then the PC 1/2 was used in this study to overcome parasite clearance time di culties and to provide an experimental early warning marker of decreased e cacy.…”

Section: Discussionmentioning

confidence: 99%

Prospective observational study of dihydroartemisinin-piperaquine treatment of vivax malaria in North Sumatera, Indonesia

Pasaribu

Said

Nasution

et al. 2022

Preprint

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Objectives. Plasmodium vivax malaria treated by dihydroartemisinin-piperaquine (DHA-PPQ) in Indonesia remains a challenge. Plasmodium falciparum resistance to DHA-PPQ was documented in Asia and it is suspected that this will also be a concern for P. vivaxmalaria. Thus it is needed to test the sensitivity of P. vivax on a regular basis. Parasite clearance time (PCT) and molecular markers of resistance are efficient sentinel tools for this goal. Methods. A prospective observational study was conducted at North Labuhan Batu Regency (Sumatra). The outcome were the clinical and parasitological efficacy of the 3-day DHA-PPQ therapy corrected by PCR and the prevalence of Pvmdr1, PvK12 and PvPM4 molecular markers of chloroquine and DHA-PPQ resistance. Results. During the 6-months study period, 100 patients were included and 6 were lost to follow-up. Ninety-four patients were included in the per-protocol analysis. The parasite clearance half-life increased over 18h in 8.5% of the cases while no clinical recurrence were observed during the Day-28 follow-up. None of the molecular marker of ACT resistance were detected among the samples tested. Conclusions. This study highlighted the need for active surveillance of ACT efficacy against P. vivax malaria in Indonesia, using simple method such as PCT during observational studies, as it may provide a cost-effective early warning signal.

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“…The African region accounted for approximately 95% of cases and 96% of deaths globally, furthermore, 80% of all malaria deaths in this region are among children under 5 years [ 4 ]. Of all malaria parasite species known to infect humans, Plasmodium falciparum is the most prevalent form in Africa and is predominantly responsible for severe malaria among children [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Estimated distribution of malaria cases among children in sub-Saharan Africa by specified age categories using data from the Global Burden of Diseases 2019

Oshagbemi,

Lopez-Romero,

Winnips

et al. 2023

Malar J

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Background Children in sub-Saharan Africa (SSA) remain the most vulnerable to malaria and malaria mortality. This study estimated the disease burden and distribution of Plasmodium falciparum malaria among children with age categories (0 to < 2 years, 2 to < 6 years, 6 to < 12 years, ≥ 12 years) in SSA. Methods Data on the number of cases and incidence rates of P. falciparum malaria by age group from the Institute of Health Metrics and Evaluation (GBD 2019) for 11 countries in SSA was employed in this study. The best-fitting distribution of P. falciparum malaria cases by prespecified age categories was derived using a combination of a Log-normal and Weibull distribution. Results Plasmodium falciparum malaria was 15.4% for ages 0 to < 2 years, 30.5% for 2 to < 6 years, 17.6% for 6 to < 12 years, and 36.5% for ≥ 12 years based on data from countries in SSA. The results have important implications for the current drive by the FDA and EMA to ensure the representativeness of real-world populations in clinical trials evaluating the safety and efficacy of medication exposure. Conclusions The theoretical distributions of P. falciparum malaria will help guide researchers in ensuring that children are appropriately represented in clinical trials and other interventions aiming to address the current burden of malaria in SSA.

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Plasmodium falciparum clearance time in Malawian children with cerebral malaria: a retrospective cohort study

Cited by 7 publications

References 18 publications

Efficacy of dihydroartemisinin-piperaquine plus primaquine treatment on vivax malaria in North Sumatera, Indonesia: a prospective observational study

Efficacy of dihydroartemisinin-piperaquine plus primaquine treatment on vivax malaria in North Sumatera, Indonesia: a prospective observational study

Prospective observational study of dihydroartemisinin-piperaquine treatment of vivax malaria in North Sumatera, Indonesia

Estimated distribution of malaria cases among children in sub-Saharan Africa by specified age categories using data from the Global Burden of Diseases 2019

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