In Vivo Efficacy and Parasite Clearance of Artesunate + Sulfadoxine-Pyrimethamine Versus Artemether-Lumefantrine in Mali

The American Journal of Tropical Medicine and Hygiene
Karamoko NiaréOgobara K Doumbo

Abstract

Although artemisinin resistance has yet to be reported in Africa, surveillance of the efficacy of artemisinin-based combination therapies (ACTs) is warranted. Here, the efficacy of artesunate + sulfadoxine-pyrimethamine (AS + SP) and artemether-lumefantrine (AL) was evaluated in Mali. Randomized open-label comparative in vivo assay of AS + SP versus AL were carried out using the 28-day follow-up World Health Organization protocol. Patients with uncomplicated falciparum malaria and at least 6 months of age were recruited between October 2010 and January 2014. A subset of these patients was selected to measure Plasmodium falciparum clearance time. Polymerase chain reaction-corrected adequate clinical and parasitological responses were 100% for AS + SP and 98.2% for AL with no significant difference (P = 0.06). The reinfection rates were comparable (P = 0.63) with 8.0% for AS + SP and 12.6% for AL. Individuals under 8 years were more susceptible to treatment failure (relative risk = 1.9; 95% confidence interval = 1.2, 3.3). Median parasite clearance half-life was 1.7 hours (interquartile range [IQR] = 1.3-2.2) for AS + SP and 1.9 hours (IQR = 1.5-2.5) for AL with no statistically significant difference (P = 0.24). Efficacy of AS +...Continue Reading

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Citations

Feb 14, 2018·The American Journal of Tropical Medicine and Hygiene·Karamoko NiaréOgobara K Doumbo
Jan 28, 2021·Tropical Medicine and Infectious Disease·Modibo DiarraIssaka Sagara
Dec 1, 2019·Phytochemistry Reviews : Proceedings of the Phytochemical Society of Europe·B M GruessnerP J Weathers
Jul 2, 2019·Médecine et maladies infectieuses·M ThellierB Pradines

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