Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.

Details

Serval ID
serval:BIB_FAE112154812
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.
Journal
Bmc Medicine
Author(s)
Abdulla  Salim, Adam  Ishag, Adjei  George O., Adjuik  Martin A., Alemayehu  Bereket, Allan  Richard, Arinaitwe  Emmanuel, Ashley  Elizabeth A., Ba  Mamadou S., Barennes  Hubert, Barnes  Karen I., Bassat  Quique, Baudin  Elisabeth, Berens-Riha  Nicole, Bjoerkman  Anders, Bompart  Francois, Bonnet  Maryline, Borrmann  Steffen, Bousema  Teun, Brasseur  Philippe, Bukirwa  Hasifa, Checchi  Francesco, Dahal  Prabin, D'Alessandro  Umberto, Desai  Meghna, Dicko  Alassane, Djimde  Abdoulaye A., Dorsey  Grant, Doumbo  Ogobara K., Drakeley  Chris J., Duparc  Stephan, Eshetu  Teferi, Espie  Emmanuelle, Etard  Jean-Francois, Faiz  Abul M., Falade  Catherine O., Fanello  Caterina I., Faucher  Jean-Francois, Faye  Babacar, Faye  Oumar, Filler  Scott, Flegg  Jennifer A., Fofana  Bakary, Fogg  Carole, Gadalla  Nahla B., Gaye  Oumar, Genton  Blaise, Gething  Peter W., Gil  Jose P., Gonzalez  Raquel, Grandesso  Francesco, Greenhouse  Bryan, Greenwood  Brian, Grivoyannis  Anastasia, Guerin  Philippe J., Guthmann  Jean-Paul, Hamed  Kamal, Hamour  Sally, Hay  Simon I., Hodel  Eva Maria, Humphreys  Georgina S., Hwang  Jimee, Ibrahim  Maman L., Jima  Daddi, Jones  Joel J., Jullien  Vincent, Juma  Elizabeth, Kachur  Patrick S., Kager  Piet A., Kamugisha  Erasmus, Kamya  Moses R., Karema  Corine, Kayentao  Kassoum, Kiechel  Jean-Rene, Kironde  Fred, Kofoed  Poul-Erik, Kremsner  Peter G., Krishna  Sanjeev, Lameyre  Valerie, Lell  Bertrand, Lima  Angeles, Makanga  Michael, Malik  ElFatih M., Marsh  Kevin, Martensson  Andreas, Massougbodji  Achille, Menan  Herve, Menard  Didier, Menendez  Clara, Mens  Petra F., Meremikwu  Martin, Moreira  Clarissa, Nabasumba  Carolyn, Nambozi  Michael, Ndiaye  Jean-Louis, Ngasala  Billy E., Nikiema  Frederic, Nsanzabana  Christian, Ntoumi  Francine, Oguike  Mary, Ogutu  Bernhards R., Olliaro  Piero, Omar  Sabah A., Ouedraogo  Jean-Bosco, Owusu-Agyei  Seth, Penali  Louis K., Pene  Mbaye, Peshu  Judy, Piola  Patrice, Plowe  Christopher V., Premji  Zul, Price  Ric N., Randrianarivelojosia  Milijaona, Rombo  Lars, Roper  Cally, Rosenthal  Philip J., Sagara  Issaka, Same-Ekobo  Albert, Sawa  Patrick, Schallig  Henk D. F. H., Schramm  Birgit, Seck  Amadou, Shekalaghe  Seif A., Sibley  Carol H., Sinou  Vronique, Sirima  Sodiomon B., Som  Fabrice A., Sow  Doudou, Staedke  Sarah G., Stepniewska  Kasia, Sutherland  Colin J., Swarthout  Todd D., Sylla  Khadime, Talisuna  Ambrose O., Taylor  Walter R. J., Temu  Emmanuel A., Thwing  Julie I., Tine  Roger C. K., Tinto  Halidou, Tommasini  Silva, Toure  Offianan A., Ursing  Johan, Vaillant  Michel T., Valentini  Giovanni, Van den Broek  Ingrid, Van Vugt  Michele, Ward  Stephen A., Winstanley  Peter A., Yavo  William, Yeka  Adoke, Zolia  Yah M., Zongo  Issaka
Working group(s)
WWARN Artemisinin based Combination Therapy (ACT) Africa Baseline Study Group
ISSN
1741-7015 (Electronic)
ISSN-L
1741-7015
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
13
Number
1
Pages
212
Language
english
Notes
Publication types: Journal ArticlePublication Status: epublishDocument Type: Review
Abstract
BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs).
METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data.
RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P <0.001); fever (>37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine).
CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.
Pubmed
Web of science
Open Access
Yes
Create date
05/10/2015 12:26
Last modification date
20/08/2019 16:26
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