Increased Sensitivity of Plasmodium falciparum to Artesunate/Amodiaquine Despite 14 Years as First-Line Malaria Treatment, Zanzibar.

Emerging Infectious Diseases
Mwinyi I MsellemAnders Björkman

Abstract

Artemisinin-based combination therapies (ACTs) are first-line treatments for uncomplicated Plasmodium falciparum malaria. ACT resistance is spreading in Asia but not yet in Africa. Reduced effects of ACT partner drugs have been reported but with little information regarding widely used artesunate/amodiaquine (ASAQ). We studied its efficacy in Zanzibar after 14 years as first-line treatment directly by an in vivo, single-armed trial and indirectly by prevalences of different genotypes in the P. falciparum chloroquine-resistance transporter, multidrug-resistance 1, and Kelch 13 propeller domain genes. In vivo efficacy was higher during 2017 (100%; 95% CI 97.4%-100%) than during 2002-2005 (94.7%; 95% CI 91.9%-96.7%) (p = 0.003). Molecular findings showed no artemisinin resistance-associated genotypes and major increases in genotypes associated with high sensitivity/efficacy for amodiaquine than before ASAQ was introduced. Thus, the efficacy of ASAQ is maintained and appears to be increased after long-term use in contrast to what is observed for other ACTs used in Africa.

References

Mar 1, 1990·Transactions of the Royal Society of Tropical Medicine and Hygiene·A Björkman, P A Phillips-Howard
Apr 20, 1999·Computers in Biology and Medicine·T Fagan
Feb 18, 2005·The Journal of Infectious Diseases·Christin SisowathJosé P Gil
Sep 16, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andreas MårtenssonAnders Björkman
Nov 8, 2005·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Gabrielle HolmgrenAnders Björkman
Nov 10, 2006·The New England Journal of Medicine·Miriam K LauferChristopher V Plowe
May 1, 2007·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Gabrielle HolmgrenAnders Björkman
Jul 11, 2007·Journal of Pharmacokinetics and Pharmacodynamics·Sofia Friberg HietalaMichael Ashton
Jun 25, 2009·Tropical Medicine & International Health : TM & IH·Netta BeerKarin Källander
Jan 20, 2010·Trends in Parasitology·Jonathan J JulianoSteven R Meshnick
Jan 21, 2010·The Journal of Infectious Diseases·Kasia StepniewskaNicholas J White
Dec 5, 2012·Antimicrobial Agents and Chemotherapy·Gabrielle FröbergJosé Pedro Gil
Feb 20, 2013·International Journal for Parasitology. Drugs and Drug Resistance·Qin ChengMichelle L Gatton
Dec 20, 2013·Nature·Frédéric ArieyDidier Ménard
Jul 24, 2014·Malaria Journal·Neelima MishraNeena Valecha
Sep 3, 2014·The Journal of Infectious Diseases·Shannon Takala-HarrisonChristopher V Plowe
Apr 19, 2015·BMC Medicine·UNKNOWN WorldWide Antimalarial Resistance Network (WWARN) AS-AQ Study GroupIssaka Zongo
Apr 29, 2015·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Ulrika MorrisAndreas Mårtensson
Dec 23, 2015·The Journal of Infectious Diseases·Stella M ChenetVenkatachalam Udhayakumar
Mar 18, 2016·Proceedings. Biological Sciences·Mary BushmanVenkatachalam Udhayakumar
Feb 6, 2018·The Lancet Infectious Diseases·Anders B Björkman
Nov 15, 2018·The New England Journal of Medicine·Sabyasachi DasSomenath Roy

❮ Previous
Next ❯

Methods Mentioned

BETA
pregnancy test
PCR
genotyping

Clinical Trials Mentioned

NCT03773536
NCT03764527
NCT03768908

Software Mentioned

Excel
Stata
ASAQ
GSPro

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.