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Sustained High Cure...
Sustained High Cure Rate of Artemether-Lumefantrine against Uncomplicated Plasmodium falciparum Malaria after 8 Years of Its Wide-Scale Use in Bagamoyo District, Tanzania
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- Mwaiswelo, Richard (författare)
- Muhimbili Univ Hlth & Allied Sci, Dept Parasitol & Med Entomol, POB 65011, Dar Es Salaam, Tanzania.
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- Ngasala, Billy (författare)
- Muhimbili Univ Hlth & Allied Sci, Dept Parasitol & Med Entomol, POB 65011, Dar Es Salaam, Tanzania.
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- Gil, J. Pedro (författare)
- Karolinska Institutet
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- Malmberg, Maja (författare)
- Swedish University of Agricultural Sciences,Sveriges lantbruksuniversitet,Inst för biomedicin och veterinär folkhälsovetenskap,Department of Biomedical Science and Veterinary Public Health
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- Jovel, Irina (författare)
- Karolinska Inst, Dept Microbiol Tumor & Cell Biol, Stockholm, Sweden.
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- Xu, Weiping (författare)
- Karolinska Inst, Dept Microbiol Tumor & Cell Biol, Stockholm, Sweden.
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- Premji, Zul (författare)
- Muhimbili Univ Hlth & Allied Sci, Dept Parasitol & Med Entomol, POB 65011, Dar Es Salaam, Tanzania.
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- Mmbando, Bruno P. (författare)
- Natl Inst Med Res, Tanga Ctr, Tanga, Tanzania.;Natl Inst Med Res, Tanga Ctr, Dept Stat & Epidemiol, Tanga, Tanzania.
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- Björkman, Anders (författare)
- Karolinska Institutet
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- Mårtensson, Andreas, 1963- (författare)
- Uppsala universitet,Internationell barnhälsa och nutrition
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Karolinska Institutet Muhimbili Univ Hlth & Allied Sci, Dept Parasitol & Med Entomol, POB 65011, Dar Es Salaam, Tanzania (creator_code:org_t)
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- AMER SOC TROP MED & HYGIENE, 2017
- 2017
- Engelska.
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Ingår i: American Journal of Tropical Medicine and Hygiene. - : AMER SOC TROP MED & HYGIENE. - 0002-9637 .- 1476-1645. ; 97:2, s. 526-532
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Abstract
Ämnesord
Stäng
- We assessed the temporal trend of artemether-lumefantrine (AL) cure rate after 8 years of its wide-scale use for treatment of uncomplicated Plasmodium falciparum malaria from 2006 to 2014 in Bagamoyo district, Tanzania. Trend analysis was performed for four studies conducted in 2006, 2007-2008, 2012-2013, and 2014. Patients with acute uncomplicated P. falciparum malaria were enrolled, treated with standard AL regimen and followed-up for 3 (2006), 28 (2014), 42 (2012-2013), or 56 (2007-2008) days for clinical and laboratory evaluation. Primary outcome was day 28 polymerase chain reaction (PCR)-adjusted cure rate across years from 2007 to 2014. Parasite clearance was slower for the 2006 and 2007-2008 cohorts with less than 50% of patients cleared of parasitemia on day 1, but was rapid for the 2012-2013 and 2014 cohorts. Day 28 PCR-adjusted cure rate was 168/170 (98.8%) (95% confidence interval [CI], 97.2-100), 122/127 (96.1%) (95% CI, 92.6-99.5), and 206/207 (99.5%) (95% CI, 98.6-100) in 2007-2008, 2012-2013, and 2014, respectively. There was no significant change in the trend of cure rate between 2007 and 2014 (chi(2)(trend) test = 0.06, P = 0.90). Pretreatment P. falciparum multidrug-resistant gene 1 (Pfmdr1) N86 prevalence increased significantly across years from 13/48 (27.1%) in 2006 to 183/213 (85.9%) in 2014 (P < 0.001), and P. falciparum chloroquine resistance transporter gene (Pfcrt) K76 prevalence increased significantly from 24/47 (51.1%) in 2006 to 198/205 (96.6%) in 2014 (P < 0.001). The AL cure rate remained high after 8 years of its wide-scale use in Bagamoyo district for the treatment of uncomplicated P. falciparum malaria despite an increase in prevalence of pretreatment Pfmdr1 N86 and Pfcrt K76 between 2006 and 2014.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
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Mwaiswelo, Richa ...
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Ngasala, Billy
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Gil, J. Pedro
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Malmberg, Maja
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Jovel, Irina
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Xu, Weiping
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Premji, Zul
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Mmbando, Bruno P ...
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Björkman, Anders
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Mårtensson, Andr ...
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