Is parasite clearance clinically important after malaria treatment in a high transmission area? A 3-month follow-up of home-based management with herbal medicine or ACT

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Ressource 1Download: serval:BIB_2C1561800CD0.P001 (289.93 [Ko])
State: Public
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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_2C1561800CD0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Is parasite clearance clinically important after malaria treatment in a high transmission area? A 3-month follow-up of home-based management with herbal medicine or ACT
Journal
Transactions of the Royal Society of Tropical Medicine and Hygiene
Author(s)
Willcox M.L., Graz B., Diakite C., Falquet J., Dackouo F., Sidibe O., Giani S., Diallo D.
ISSN
1878-3503 (Electronic)
ISSN-L
0035-9203
Publication state
Published
Issued date
2010
Volume
105
Number
1
Pages
23-31
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Argemone mexicana (AM), a validated herbal medicine for uncomplicated malaria, seems to prevent severe malaria without completely clearing parasites in most patients. This study, in a high transmission area of South Mali, explores whether residual parasitaemia at day 28 was associated with subsequent malaria episodes and/or anaemia. Three hundred and one patients were randomly assigned to AM or artesunate/amodiaquine as first line treatment, of whom 294 were followed up beyond the standard 28 days, to 84 days. From day 29 to day 84, there were no significant differences between treatment groups in new clinical episodes of uncomplicated malaria (0.33 vs 0.31 episodes/patient), severe malaria (< 6% per month of patients aged ≤ 5 years) or moderate anaemia (hematocrit < 24%: 1.1% in both groups at day 84). Total parasite clearance at day 28 was not correlated with incidence of uncomplicated or severe malaria or of moderate anaemia over the subsequent two months. Total parasite clearance at day 28 was not clinically important in the context of high transmission. If this finding can be confirmed, some antimalarials which are clinically effective but do not completely clear parasites could nevertheless be appropriate in high transmission areas. Such a policy could be tested as a way to delay resistance to artemisinin combination therapies.
Keywords
Amodiaquine/administration & dosage, Amodiaquine/adverse effects, Antimalarials/administration & dosage, Antimalarials/adverse effects, Artemisinins/administration & dosage, Artemisinins/adverse effects, Malaria/drug therapy, Malaria/epidemiology, Malaria/parasitology, Malaria/transmission, Mali/epidemiology, Medication Adherence/statistics & numerical data, Plant Preparations/administration & dosage, Plant Preparations/adverse effects
Pubmed
Web of science
Open Access
Yes
Create date
13/07/2018 10:00
Last modification date
01/10/2019 7:17
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