1
|
Toure OA, Landry TN, Assi SB, Kone AA, Gbessi EA, Ako BA, Coulibaly B, Kone B, Ouattara O, Beourou S, Koffi A, Remoue F, Rogier C. Malaria parasite clearance from patients following artemisinin-based combination therapy in Côte d'Ivoire. Infect Drug Resist 2018; 11:2031-2038. [PMID: 30464545 PMCID: PMC6208791 DOI: 10.2147/idr.s167518] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction Parasite clearance is useful to detect artemisinin resistance. The aim of this study was to investigate parasite clearance in patients treated with artesunate + amodiaquine (AS + AQ) and artemether + lumefantrine (AL): the two artemisinin-based combination therapies (ACTs) recommended in the first-line treatment of uncomplicated malaria in Côte d’Ivoire. Methods This study was conducted in Bouaké, Côte d’Ivoire, from April to June 2016. Patients aged at least 6 months with uncomplicated malaria and treated with AS + AQ or AL were hospitalized for 3 days, and follow-up assessments were performed on days 3, 7, 14, 21, 28, 35, and 42. Blood smears were collected at the time of screening, pre-dose, and 6-hour intervals following the first dose of administration until two consecutive negative smears were recorded, thereafter at day 3 and follow-up visits. Parasite clearance was determined using the Worldwide Antimalarial Resistance Network’s parasite clearance estimator. The primary end points were parasite clearance rate and time. Results A total of 120 patients (57 in the AS + AQ group and 63 in the AL group) were randomized among 298 patients screened. The median parasite clearance time was 30 hours (IQR, 24–36 hours), for each ACT. The median parasite clearance rate had a slope half-life of 2.36 hours (IQR, 1.85–2.88 hours) and 2.23 hours (IQR, 1.74–2.63 hours) for AS + AQ and AL, respectively. The polymerase chain reaction-corrected adequate clinical and parasitological response was 100% and 98.07% at day 42 for AS + AQ and AL, respectively. Conclusion Patients treated with AS + AQ and AL had cleared parasites rapidly. ACTs are still efficacious in Bouaké, Côte d’Ivoire, but continued efficacy monitoring of ACTs is needed.
Collapse
Affiliation(s)
| | | | - Serge Brice Assi
- Malaria and Anopheles Research and Management Unit, Pierre Richet Institute, Bouake, Côte d'Ivoire.,National Malaria Control Program, Bouake, Côte d'Ivoire
| | | | - Eric Adji Gbessi
- Malariology Unit, Pasteur Institute of Côte d'Ivoire, Abidjan, Côte d'Ivoire,
| | | | - Baba Coulibaly
- Malariology Unit, Pasteur Institute of Côte d'Ivoire, Abidjan, Côte d'Ivoire,
| | - Bouakary Kone
- Department of Medicine, Health Care Center of Dar-Es-Salam, Bouake, Côte d'Ivoire
| | - Oumar Ouattara
- Department of Medicine, Health Care Center of Dar-Es-Salam, Bouake, Côte d'Ivoire
| | - Sylvain Beourou
- Malariology Unit, Pasteur Institute of Côte d'Ivoire, Abidjan, Côte d'Ivoire,
| | - Alphonsine Koffi
- Malaria and Anopheles Research and Management Unit, Pierre Richet Institute, Bouake, Côte d'Ivoire
| | - Franck Remoue
- Malaria and Anopheles Research and Management Unit, Pierre Richet Institute, Bouake, Côte d'Ivoire.,UMR 224-MIVEGEC, Research Development Institute, Montpellier, France
| | | |
Collapse
|