Predictors of residual antimalarial drugs in the blood in community surveys in Tanzania.

Details

Serval ID
serval:BIB_05548CB69DD5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predictors of residual antimalarial drugs in the blood in community surveys in Tanzania.
Journal
PloS one
Author(s)
Gallay J., Pothin E., Mosha D., Lutahakana E., Mazuguni F., Zuakulu M., Decosterd L.A., Genton B.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
13
Number
9
Pages
e0202745
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Understanding pattern of antimalarials use at large scale helps ensuring appropriate use of treatments and preventing the spread of resistant parasites. We estimated the proportion of individuals in community surveys with residual antimalarials in their blood and identified the factors associated with the presence of the most commonly detected drugs, lumefantrine and/or desbutyl-lumefantrine (LF/DLF) or sulfadoxine-pyrimethamine (SP).
A cross-sectional survey was conducted in 2015 in three regions of Tanzania with different levels of malaria endemicity. Interviews were conducted and blood samples collected through household surveys for further antimalarial measurements using liquid chromatography coupled to tandem mass spectrometry. In addition, diagnosis and treatment availability was investigated through outlet surveys. Multilevel mixed effects logistic regression models were used to estimate odds ratios for having LF/DLF or SP in the blood.
Amongst 6391 participants, 12.4% (792/6391) had LF/DLF and 8.0% (510/6391) SP in the blood. Factors associated with higher odds of detecting LF/DLF in the blood included fever in the previous two weeks (OR = 2.6, p<0.001), living in districts of higher malaria prevalence (OR = 1.5, p<0.001) and living in a ward in which all visited drug stores had artemisinin-based combination therapies in stocks (OR = 2.7, p = 0.020). Participants in older age groups were less likely to have LF/DLF in the blood (OR = 0.9, p<0.001). Factors associated with higher odds of having SP in the blood included being pregnant (OR = 4.6, p<0.001), living in Mwanza (OR = 3.9, p<0.001 compared to Mbeya), fever in the previous two weeks (OR = 1.7, p<0.001) and belonging to older age groups (OR = 1.2, p<0.001).
The most significant predictors identified were expected. History of fever in the past two weeks and young age were significant predictors of LF/DLF in the blood, which is encouraging. Antimalarial drug pressure was high and hence the use of recommended first-line drugs in combination with malaria Rapid Diagnostics Tests should be promoted to ensure appropriate treatment.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Antimalarials/blood, Antimalarials/therapeutic use, Child, Child, Preschool, Cross-Sectional Studies, Drug Residues/analysis, Female, Humans, Infant, Infant, Newborn, Malaria/blood, Malaria/drug therapy, Male, Middle Aged, Surveys and Questionnaires, Tanzania, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
19/09/2018 12:50
Last modification date
20/08/2019 12:27
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