Artemether-lumefantrine versus artemisinin-naphthoquine in Papua New Guinean children with uncomplicated malaria: a six months post-treatment follow-up study

Malaria Journal

Research

Mary Salib¹  Somoyang Tawat¹  Peter M Siba¹  John M Benjamin¹  Leanne J Robinson²  Timothy ME Davis³  Wendy A Davis³  Moses Laman⁴  Brioni R Moore⁴ 

[1] Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea;Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea;Infection and Immunity Division, Walter and Eliza Hall Institute, Parkville, VIC, Australia;Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia;School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, 6959, Fremantle, WA, Australia;School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, 6959, Fremantle, WA, Australia;Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea;

关键词: Malaria;    Plasmodium falciparum;    Plasmodium vivax;    Artemisinin combination therapy;    Naphthoquine;    Effectiveness;   

DOI  :  10.1186/s12936-015-0624-4

 received in 2015-01-14, accepted in 2015-02-20,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn a recent trial of artemisinin-naphthoquine (artemisinin-NQ) and artemether-lumefantrine (AM-LM) therapy in young children from Papua New Guinea (PNG), there were no treatment failures in artemisinin-NQ-treated children with Plasmodium falciparum or Plasmodium vivax compared with 2.2% and 30.0%, respectively, in AM-LM-treated children during 42 days of follow-up. To determine whether, consistent with the long elimination half-life of NQ, this difference in efficacy would be more durable, clinical episodes of malaria were assessed in a subset of trial patients followed for six months post-treatment.MethodsFor children completing trial procedures and who were assessable at six months, all within-trial and subsequent clinical malaria episodes were ascertained, the latter by clinic attendances and/or review of hand-held health records. Presentations with non-malarial illness were also recorded. Differences between allocated treatments for pre-specified endpoints were determined using Kaplan-Meier survival analysis.ResultsOf 247 children who were followed to Day 42, 176 (71.3%) were included in the present sub-study, 87 allocated to AM-LM and 89 to artemisinin-NQ. Twenty children in the AM-LM group (32.8%) had a first episode of clinical malaria within six months compared with 10 (16.4%) in the artemisinin-NQ group (P = 0.033, log rank test). The median (interquartile range) time to first episode of clinical malaria was 64 (50–146) vs 116 (77–130) days, respectively (P = 0.20). There were no between-group differences in the incidence of first presentation with non-malarial illness (P = 0.31).ConclusionsThe greater effectiveness of artemisinin-NQ over conventional AM-LM extends to at least six months post-treatment for clinical malaria but not non-malarial illness.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12610000913077.

【 授权许可】

Unknown   
© Laman et al.; licensee BioMed Central. 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.