Sökning: onr:"20193961" > Clinical determinan...
Fältnamn | Indikatorer | Metadata |
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000 | 10179naa a22022573a 4500 | |
001 | 20193961 | |
003 | SE-LIBR | |
005 | 20170323175406.0 | |
007 | cr|||||||||||| | |
008 | 170323s2015 sw |||| o |||| ||eng c | |
024 | 7 | a http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2659562 uri |
024 | 7 | a urn:nbn:se:uu:diva-2659562 urn |
024 | 7 | a 10.1186/s12916-015-0445-x2 doi |
040 | a S | |
041 | 0 | a eng |
042 | 9 EPLK | |
100 | 1 | a Abdulla, Salim4 aut |
245 | 1 0 | a Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malariah [Elektronisk resurs]b a literature review and meta-analysis of individual patient data |
260 | c 2015 | |
500 | a Published | |
506 | 0 | a gratis |
520 | a 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 degrees 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. | |
650 | 7 | a Medical and Health Sciences2 hsv |
650 | 7 | a Clinical Medicine2 hsv |
650 | 7 | a Infectious Medicine2 hsv |
650 | 7 | a Medicin och hälsovetenskap2 hsv |
650 | 7 | a Klinisk medicin2 hsv |
650 | 7 | a Infektionsmedicin2 hsv |
700 | 1 | a Adam, Ishag4 aut |
700 | 1 | a Adjei, George O.4 aut |
700 | 1 | a Adjuik, Martin A.4 aut |
700 | 1 | a Alemayehu, Bereket4 aut |
700 | 1 | a Allan, Richard4 aut |
700 | 1 | a Arinaitwe, Emmanuel4 aut |
700 | 1 | a Ashley, Elizabeth A.4 aut |
700 | 1 | a Ba, Mamadou S.4 aut |
700 | 1 | a Barennes, Hubert4 aut |
700 | 1 | a Barnes, Karen I.4 aut |
700 | 1 | a Bassat, Quique4 aut |
700 | 1 | a Baudin, Elisabeth4 aut |
700 | 1 | a Berens-Riha, Nicole4 aut |
700 | 1 | a Bjoerkman, Anders4 aut |
700 | 1 | a Bompart, Francois4 aut |
700 | 1 | a Bonnet, Maryline4 aut |
700 | 1 | a Borrmann, Steffen4 aut |
700 | 1 | a Bousema, Teun4 aut |
700 | 1 | a Brasseur, Philippe4 aut |
700 | 1 | a Bukirwa, Hasifa4 aut |
700 | 1 | a Checchi, Francesco4 aut |
700 | 1 | a Dahal, Prabin4 aut |
700 | 1 | a D'Alessandro, Umberto4 aut |
700 | 1 | a Desai, Meghna4 aut |
700 | 1 | a Dicko, Alassane4 aut |
700 | 1 | a Djimde, Abdoulaye A.4 aut |
700 | 1 | a Dorsey, Grant4 aut |
700 | 1 | a Doumbo, Ogobara K.4 aut |
700 | 1 | a Drakeley, Chris J.4 aut |
700 | 1 | a Duparc, Stephan4 aut |
700 | 1 | a Eshetu, Teferi4 aut |
700 | 1 | a Espie, Emmanuelle4 aut |
700 | 1 | a Etard, Jean-Francois4 aut |
700 | 1 | a Faiz, Abul M.4 aut |
700 | 1 | a Falade, Catherine O.4 aut |
700 | 1 | a Fanello, Caterina I.4 aut |
700 | 1 | a Faucher, Jean-Francois4 aut |
700 | 1 | a Faye, Babacar4 aut |
700 | 1 | a Faye, Oumar4 aut |
700 | 1 | a Filler, Scott4 aut |
700 | 1 | a Flegg, Jennifer A.4 aut |
700 | 1 | a Fofana, Bakary4 aut |
700 | 1 | a Fogg, Carole4 aut |
700 | 1 | a Gadalla, Nahla B.4 aut |
700 | 1 | a Gaye, Oumar4 aut |
700 | 1 | a Genton, Blaise4 aut |
700 | 1 | a Gething, Peter W.4 aut |
700 | 1 | a Gil, Jose P.4 aut |
700 | 1 | a Gonzalez, Raquel4 aut |
700 | 1 | a Grandesso, Francesco4 aut |
700 | 1 | a Greenhouse, Bryan4 aut |
700 | 1 | a Greenwood, Brian4 aut0 57188 |
700 | 1 | a Grivoyannis, Anastasia4 aut |
700 | 1 | a Guerin, Philippe J.4 aut |
700 | 1 | a Guthmann, Jean-Paul4 aut |
700 | 1 | a Hamed, Kamal4 aut |
700 | 1 | a Hamour, Sally4 aut |
700 | 1 | a Hay, Simon I.4 aut |
700 | 1 | a Hodel, Eva Maria4 aut |
700 | 1 | a Humphreys, Georgina S.4 aut |
700 | 1 | a Hwang, Jimee4 aut |
700 | 1 | a Ibrahim, Maman L.4 aut |
700 | 1 | a Jima, Daddi4 aut |
700 | 1 | a Jones, Joel J.4 aut |
700 | 1 | a Jullien, Vincent4 aut |
700 | 1 | a Juma, Elizabeth4 aut |
700 | 1 | a Kachur, Patrick S.4 aut |
700 | 1 | a Kager, Piet A.4 aut |
700 | 1 | a Kamugisha, Erasmus4 aut |
700 | 1 | a Kamya, Moses R.4 aut |
700 | 1 | a Karema, Corine4 aut |
700 | 1 | a Kayentao, Kassoum4 aut |
700 | 1 | a Kiechel, Jean-Rene4 aut |
700 | 1 | a Kironde, Fred4 aut |
700 | 1 | a Kofoed, Poul-Erik4 aut |
700 | 1 | a Kremsner, Peter G.4 aut |
700 | 1 | a Krishna, Sanjeev4 aut |
700 | 1 | a Lameyre, Valerie4 aut |
700 | 1 | a Lell, Bertrand4 aut |
700 | 1 | a Lima, Angeles4 aut |
700 | 1 | a Makanga, Michael4 aut |
700 | 1 | a Malik, ElFatih M.4 aut |
700 | 1 | a Marsh, Kevin4 aut |
700 | 1 | a Mårtensson, Andreas4 aut |
700 | 1 | a Massougbodji, Achille4 aut |
700 | 1 | a Menan, Herve4 aut |
700 | 1 | a Menard, Didier4 aut |
700 | 1 | a Menendez, Clara4 aut |
700 | 1 | a Mens, Petra F.4 aut |
700 | 1 | a Meremikwu, Martin4 aut |
700 | 1 | a Moreira, Clarissa4 aut |
700 | 1 | a Nabasumba, Carolyn4 aut |
700 | 1 | a Nambozi, Michael4 aut |
700 | 1 | a Ndiaye, Jean-Louis4 aut |
700 | 1 | a Ngasala, Billy E.4 aut |
700 | 1 | a Nikiema, Frederic4 aut |
700 | 1 | a Nsanzabana, Christian4 aut |
700 | 1 | a Ntoumi, Francine4 aut |
700 | 1 | a Oguike, Mary4 aut |
700 | 1 | a Ogutu, Bernhards R.4 aut |
700 | 1 | a Olliaro, Piero4 aut |
700 | 1 | a Omar, Sabah A.4 aut |
700 | 1 | a Ouedraogo, Jean-Bosco4 aut |
700 | 1 | a Owusu-Agyei, Seth4 aut |
700 | 1 | a Penali, Louis K.4 aut |
700 | 1 | a Pene, Mbaye4 aut |
700 | 1 | a Peshu, Judy4 aut |
700 | 1 | a Piola, Patrice4 aut |
700 | 1 | a Plowe, Christopher V.4 aut |
700 | 1 | a Premji, Zul4 aut |
700 | 1 | a Price, Ric N.4 aut |
700 | 1 | a Randrianarivelojosia, Milijaona4 aut |
700 | 1 | a Rombo, Lars4 aut |
700 | 1 | a Roper, Cally4 aut |
700 | 1 | a Rosenthal, Philip J.4 aut |
700 | 1 | a Sagara, Issaka4 aut |
700 | 1 | a Same-Ekobo, Albert4 aut |
700 | 1 | a Sawa, Patrick4 aut |
700 | 1 | a Schallig, Henk D. F. H.4 aut |
700 | 1 | a Schramm, Birgit4 aut |
700 | 1 | a Seck, Amadou4 aut |
700 | 1 | a Shekalaghe, Seif A.4 aut |
700 | 1 | a Sibley, Carol H.4 aut |
700 | 1 | a Sinou, Vronique4 aut |
700 | 1 | a Sirima, Sodiomon B.4 aut |
700 | 1 | a Som, Fabrice A.4 aut |
700 | 1 | a Sow, Doudou4 aut |
700 | 1 | a Staedke, Sarah G.4 aut |
700 | 1 | a Stepniewska, Kasia4 aut |
700 | 1 | a Sutherland, Colin J.4 aut |
700 | 1 | a Swarthout, Todd D.4 aut |
700 | 1 | a Sylla, Khadime4 aut |
700 | 1 | a Talisuna, Ambrose O.4 aut |
700 | 1 | a Taylor, Walter R. J.4 aut |
700 | 1 | a Temu, Emmanuel A.4 aut |
700 | 1 | a Thwing, Julie I.4 aut |
700 | 1 | a Tine, Roger C. K.4 aut |
700 | 1 | a Tinto, Halidou4 aut |
700 | 1 | a Tommasini, Silva4 aut |
700 | 1 | a Toure, Offianan A.4 aut |
700 | 1 | a Ursing, Johan4 aut |
700 | 1 | a Vaillant, Michel T.4 aut |
700 | 1 | a Valentini, Giovanni4 aut0 98656 |
700 | 1 | a Van den Broek, Ingrid4 aut |
700 | 1 | a Van Vugt, Michele4 aut |
700 | 1 | a Ward, Stephen A.4 aut |
700 | 1 | a Winstanley, Peter A.4 aut |
700 | 1 | a Yavo, William4 aut |
700 | 1 | a Yeka, Adoke4 aut |
700 | 1 | a Zolia, Yah M.4 aut |
700 | 1 | a Zongo, Issaka4 aut |
710 | 1 2 | a Uppsala universitetb Medicinska och farmaceutiska vetenskapsområdet4 pbl |
772 | 1 8 | i channel recordw 19753896 |
773 | 0 8 | i Värdpublikationt BMC Medicineg 13x 1741-7015 |
856 | 4 0 | u http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-265956 |
856 | 4 0 | u http://dx.doi.org/10.1186/s12916-015-0445-x |
856 | 4 0 | u http://uu.diva-portal.org/smash/get/diva2:867192/FULLTEXT01 |
900 | 1 s | 6 700a Greenwood, B.u Greenwood, Brian |
900 | 1 s | 6 700a Valentini, Giovanni.t Sonat, blockflöjt (3), violin (2), viola (3),b.c.u Valentini, Giovanni |
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024 | 7 | 5 APISa urn:nbn:se:uu:diva-2659562 urn |
852 | 5 APISb APIS | |
856 | 4 0 | 5 APISu http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-265956 |
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