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Konate D, Diawara SI, Sogoba N, Shaffer J, Keita B, Cisse A, Sanogo I, Dicko I, Guindo MDA, Balam S, Traore A, Kante S, Dembele A, Kasse F, Denou L, Diakite SA, Traore K, M'Baye Thiam S, Sanogo V, Toure M, Diarra A, Agak GW, Doumbia S, Diakite M. Effect of a fifth round of seasonal malaria chemoprevention in children aged 5-14 years in Dangassa, an area of long transmission in Mali. Parasite Epidemiol Control 2023; 20:e00283. [PMID: 36704118 PMCID: PMC9871299 DOI: 10.1016/j.parepi.2022.e00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/06/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
Despite a significant reduction in the burden of malaria in children under five years-old, the efficient implementation of seasonal malaria chemoprevention (SMC) at large scale remains a major concern in areas with long malaria transmission. Low coverage rate in the unattainable areas during the rainy season, a shift in the risk of malaria to older children and the rebound in malaria incidence after stopping drug administration are mainly reported in these areas. These gaps represent a major challenge in the efficient implementation of SMC measures. An open randomized study was conducted to assess the effect of a fifth additional round to current regime of SMC in older children living in Dangassa, a rural malaria endemic area. Poisson regression Model was used to estimate the reduction in malaria incidence in the intervention group compared to the control group including age groups (5-9 and 10-14 years) and the use of long-lasting insecticidal nets (LLINs; Yes or No) with a threshold at 5%. Overall, a downward trend in participation rate was observed from August (94.3%) to November (87.2%). In November (round 4), the risk of malaria incidence was similar in both groups (IRR = 0.66, 95%CI [0.35-1.22]). In December (round 5), a decrease of 51% in malaria incidence was observed in intervention group compared to control group adjusted for age groups and the use of LLINs (IRR = 0.49, 95%CI [0.26-0.94]), of which 17% of reduction is attributable to the 5th round in the intervention group. An additional fifth round of SMC resulted in a significant reduction of malaria incidence in the intervention group. The number of SMC rounds could be adapted to the local condition of malaria transmission.
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Affiliation(s)
- Drissa Konate
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
- Corresponding author.
| | - Sory I. Diawara
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Nafomon Sogoba
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Jeff Shaffer
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Bourama Keita
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Abdourhamane Cisse
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Ibrahim Sanogo
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Ilo Dicko
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Merepen dite Agnes Guindo
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Saidou Balam
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Abdouramane Traore
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Salimata Kante
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Assitan Dembele
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Fatoumata Kasse
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Larissa Denou
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Seidina A.S. Diakite
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Karim Traore
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sidibe M'Baye Thiam
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Vincent Sanogo
- National Malaria Control Program, Ministry of Health, Bamako, Mali
| | - Mahamoudou Toure
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Ayouba Diarra
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - George W. Agak
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Seydou Doumbia
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou Diakite
- International Center for Excellence in Research, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
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Villa M, Buysse M, Berthomieu A, Rivero A. The transmission-blocking effects of antimalarial drugs revisited: fitness costs and sporontocidal effects of artesunate and sulfadoxine-pyrimethamine. Int J Parasitol 2021; 51:279-289. [PMID: 33508331 DOI: 10.1016/j.ijpara.2020.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022]
Abstract
Assays used to evaluate the transmission-blocking activity of antimalarial drugs are largely focused on their potential to inhibit or reduce the infectivity of gametocytes, the blood stages of the parasite that are responsible for the onward transmission to the mosquito vector. For this purpose, the drug is administered concomitantly with gametocyte-infected blood, and the results are evaluated as the percentage of reduction in the number of oocysts in the mosquito midgut. We report the results of a series of experiments that explore the transmission-blocking potential of two key antimalarial drugs, artesunate and sulfadoxine-pyrimethamine, when administered to mosquitoes already infected from a previous blood meal. For this purpose, uninfected mosquitoes and mosquitoes carrying a 6 day old Plasmodium relictum infection (early oocyst stages) were allowed to feed either on a drug-treated or an untreated host in a fully factorial experiment. This protocol allowed us to bypass the gametocyte stages and establish whether the drugs have a sporontocidal effect, i.e. whether they are able to arrest the ongoing development of oocysts and sporozoites, as would be the case when a mosquito takes a post-infection treated blood meal. In a separate experiment, we also explored whether a drug-treated blood meal impacted key life history traits of the mosquito relevant for transmission, and if this depended on their infection status. Our results showed that feeding on an artesunate- or sulfadoxine-pyrimethamine-treated hosts has no epidemiologically relevant effects on the fitness of infected or uninfected mosquitoes. In contrast, when infected mosquitoes fed on an sulfadoxine-pyrimethamine-treated host, we observed both a significant increase in the number of oocysts in the midgut, and a drastic decrease in both sporozoite prevalence (-30%) and burden (-80%) compared with the untreated controls. We discuss the potential mechanisms underlying these seemingly contradictory results and contend that, provided the results are translatable to human malaria, the potential epidemiological and evolutionary consequences of the current preventive use of sulfadoxine-pyrimethamine in malaria-endemic countries could be substantial.
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Affiliation(s)
- M Villa
- MIVEGEC (CNRS - IRD - Université de Montpellier), France.
| | - M Buysse
- MIVEGEC (CNRS - IRD - Université de Montpellier), France
| | - A Berthomieu
- MIVEGEC (CNRS - IRD - Université de Montpellier), France; CREES (Centre d'Écologie et Évolution de la Santé, Montpellier), 911 avenue Agropolis, 34394 Montpellier, France
| | - A Rivero
- MIVEGEC (CNRS - IRD - Université de Montpellier), France; CREES (Centre d'Écologie et Évolution de la Santé, Montpellier), 911 avenue Agropolis, 34394 Montpellier, France
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Gruessner BM, Cornet-Vernet L, Desrosiers MR, Lutgen P, Towler MJ, Weathers PJ. It is not just artemisinin: Artemisia sp. for treating diseases including malaria and schistosomiasis. PHYTOCHEMISTRY REVIEWS : PROCEEDINGS OF THE PHYTOCHEMICAL SOCIETY OF EUROPE 2019; 18:1509-1527. [PMID: 33911989 PMCID: PMC8078015 DOI: 10.1007/s11101-019-09645-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 09/11/2019] [Indexed: 05/13/2023]
Abstract
Artemisia sp., especially A. annua and A. afra, have been used for centuries to treat many ailments. While artemisinin is the main therapeutically active component, emerging evidence demonstrates that the other phytochemicals in this genus are also therapeutically active. Those compounds include flavonoids, other terpenes, coumarins, and phenolic acids. Artemisia sp. phytochemicals also improve bioavailability of artemisinin and synergistically improve artemisinin therapeutic efficacy, especially when delivered as dried leaf Artemisia as a tea infusion or as powdered dry leaves in a capsule or compressed into a tablet. Here results from in vitro, and in vivo animal and human studies are summarized and critically discussed for mainly malaria, but also other diseases susceptible to artemisinin and Artemisia sp. including schistosomiasis, leishmaniasis, and trypanosomiasis.
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Affiliation(s)
- B M Gruessner
- Department of Biology and Biotechnology, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, USA
| | | | - M R Desrosiers
- Department of Biology and Biotechnology, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, USA
| | - P Lutgen
- IFVB-BELHERB, Niederanven, Luxembourg
| | - M J Towler
- Department of Biology and Biotechnology, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, USA
| | - P J Weathers
- Department of Biology and Biotechnology, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, USA
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Sowunmi A, Fatunmbi B, Akano K, Wewe OA, Agomo C, Finomo F, Ebenebe J, Jiya N, Ambe J, Wammanda R, Ntadom G, Mokuolu O, Emechebe G, Ezeigwe N, Ayede AI, Adewoye EO, Gbotosho GO, Folarin OA, Happi CT, Oguche S, Oyibo WA, Useh F. Factors contributing to anaemia after uncomplicated falciparum malaria in under five year-old Nigerian children ten years following adoption of artemisinin-based combination therapies as first-line antimalarials. BMC Infect Dis 2017; 17:781. [PMID: 29258448 PMCID: PMC5738206 DOI: 10.1186/s12879-017-2876-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/30/2017] [Indexed: 11/23/2022] Open
Abstract
Background Artemisinin-based combination therapies (ACTs) have remained efficacious treatments of acute falciparum malaria in many endemic areas but there is little evaluation of factors contributing to the anaemia of acute falciparum malaria following long term adoption of ACTs as first-line antimalarials in African children. Methods Malarious <5 year-olds randomized to artemether-lumefantrine, artesunate-amodiaquine or dihydroartemisinin-piperaquine treatments were followed up clinically for 6 weeks. Anaemia was defined as haematocrit <30%; Malaria-attributable fall in haematocrit (MAFH) as the difference between haematocrit 28–42 days post- and pre-treatment; Total MAFH (TMAFH) as the difference between days 28–42 haematocrit and the lowest haematocrit recorded in the first week post-treatment initiation; Drug-attributable fall in haematocrit (DAFH) as the difference between MAFH and TMAFH; Early appearing anaemia (EAA) as haematocrit <30% occurring within 1 week in children with normal haematocrit pre-treatment. Predictors of anaemia pre-treatment, EAA, MAFH or DAFH >4% were evaluated by stepwise multiple logistic regression models. Survival analysis and kinetics of DAFH were evaluated by Kaplan-Meier estimator and non-compartment model, respectively. Results Pre-treatment, 355 of 959 children were anaemic. Duration of illness >2 days and parasitaemia ≤10,000 μL−1 were independent predictors of anaemia pre-treatment. EAA occurred in 301 of 604 children. Predictors of EAA were age ≤ 15 months, history of fever pre-treatment and enrolment haematocrit ≤35%. The probabilities of progression from normal haematocrit to EAA were similar for all treatments. MAFH >4% occurred in 446 of 694 children; its predictors were anaemia pre-treatment, enrolment parasitaemia ≤50,000 μL−1, parasitaemia one day post-treatment initiation and gametocytaemia. DAFH >4% occurred in 334 of 719 children; its predictors were history of fever pre-and fever 1 day post-treatment initiation, haematocrit ≥37%, and parasitaemia >100,000 μL−1. In 432 children, declines in DAFH deficits were monoexponential with overall estimated half-time of 2.2d (95% CI 1.9–2.6). Area under curve of deficits in DAFH versus time and estimated half-time were significantly higher in non-anaemic children indicating greater loss of haematocrit in these children. Conclusion After ten years of adoption of ACTs, anaemia is common pre-and early post-treatment, falls in haematocrit attributable to a single infection is high, and DAFH >4% is common and significantly lower in anaemic compared to non-anaemic Nigerian children. Trial registration Pan African Clinical Trial Registry (PACTR) [PACTR201709002064150, 1 March 2017].
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Affiliation(s)
- Akintunde Sowunmi
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria. .,Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria. .,Institute for Medical Research and Training, University of Ibadan, Ibadan, Nigeria. .,Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria.
| | - Bayo Fatunmbi
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,World Health Organization, Country Office, Kampala, Uganda
| | - Kazeem Akano
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria
| | - Olubunmi A Wewe
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria
| | - Chimere Agomo
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Medical Laboratory Science, University of Lagos, Lagos, Nigeria
| | - Finomo Finomo
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, Federal Medical Centre, Yenagoa, Nigeria
| | - Joy Ebenebe
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, Nnamdi Azikiwe University, Awka, Nigeria
| | - Nma Jiya
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, Uthman Dan Fodio University, Sokoto, Nigeria
| | - Jose Ambe
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, University of Maiduguri, Maiduguri, Nigeria
| | - Robinson Wammanda
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, Ahmadu Bello University, Zaria, Nigeria
| | - Godwin Ntadom
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria
| | - Olugbenga Mokuolu
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, University of Ilorin, Ilorin, Nigeria
| | - George Emechebe
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, Imo State University Teaching Hospital, Orlu, Nigeria
| | - Nnenna Ezeigwe
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria
| | | | - Elsie O Adewoye
- Department of Physiology, University of Ibadan, Ibadan, Nigeria
| | - Grace O Gbotosho
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria.,Institute for Medical Research and Training, University of Ibadan, Ibadan, Nigeria.,Department of Pharmacology and Toxicology, University of Ibadan, Ibadan, Nigeria
| | - Onikepe A Folarin
- Department of Biological Sciences and African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer University, Ede, Nigeria
| | - Christian T Happi
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Biological Sciences and African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer University, Ede, Nigeria
| | - Stephen Oguche
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Paediatrics, University of Jos, Jos, Nigeria
| | - Wellington A Oyibo
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Medical Microbiology and Parasitology, University of Lagos, Lagos, Nigeria
| | - Francis Useh
- Antimalarial Therapeutic Efficacy Monitoring Group, National Malaria Elimination Programme, The Federal Ministry of Health, Abuja, Nigeria.,Department of Medical Laboratory Science, University of Calabar, Calabar, Nigeria
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