Malaria burden and anti-malarial drug efficacy in Owando, northern Congo

Malaria Journal

Research

Rigobert Mbouka¹  Louis R. Dossou-Yovo²  Leonardo K. Basco³  Kim Yen Ha Nguyen⁴  Hervé Bogreau⁵  Bruno Pradines⁶  Prisca N. Casimiro⁷  Mathieu Ndounga⁷  Brice P. Singana⁷  Brunelle D. Matondo⁷ 

[1] Direction Départementale de la Santé (DDS) de la Cuvette, Owando, Republic of Congo;Laboratoire National de Santé Publique (LNSP), BP 120, Brazzaville, Republic of Congo;Unité de Parasitologie et d’Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France;Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix-Marseille Université, Marseille, France;Unité de Parasitologie et d’Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France;Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix-Marseille Université, Marseille, France;Centre National de Référence du Paludisme région Antilles-Guyane, Laboratoire de Parasitologie, Institut Pasteur de la Guyane, Cayenne, France;Unité de Parasitologie et d’Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France;Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix-Marseille Université, Marseille, France;Centre National de Référence du Paludisme région Antilles-Guyane, Laboratoire de Parasitologie, Institut Pasteur de la Guyane, Cayenne, France;Direction interarmées du service de santé, Cayenne, France;Unité de Parasitologie et d’Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France;Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix-Marseille Université, Marseille, France;Centre National de Référence du Paludisme, Marseille, France;Unité de Recherche sur le Paludisme, Centre d’Etudes sur les Ressources Végétales (CERVE), BP 1249, Brazzaville, Republic of Congo;

关键词: Malaria;    Plasmodium falciparum;    Anti-malarial drug;    Drug resistance;    Microscopy;    Rapid diagnostic test;    Artemisinin;    Combination therapy;    Congo-Brazzaville;   

DOI  :  10.1186/s12936-015-1078-4

 received in 2015-06-22, accepted in 2015-12-29,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIn the Republic of Congo, previous epidemiological studies have only been conducted in the south of the country where it is most accessible. Nationally representative data on the efficacy of new anti-malarial tools are lacking in the country. As an initial step to close the gap, clinical efficacy of two artemisinin-based combinations, artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL), was assessed in Owando, a city in equatorial flooded forest in northern Republic of Congo.MethodsUnder 12 years old febrile children attending public health facilities were screened for malaria parasites using lactate dehydrogenase (LDH)-based rapid diagnostic test (RDT) for malaria and microscopic examination of thick blood films. Patients with at least 1,000 asexual Plasmodium falciparum parasites/µl of blood were clinically examined, included after informed consent, and followed up for 28 days, according to the 2009 World Health Organization protocol. Patients were randomly assigned to co-formulated ASAQ (Coarsucam®) or AL (Coartem®) treatment groups. Plasmodium falciparum recrudescent isolates were compared to pre-treatment isolates by polymerase chain reaction (PCR) using msp1, msp2, and glurp genes to distinguish between re-infection and recrudescence.ResultsBetween November 2012 and February 2013, 857 under 12 years old febrile children were screened, of whom 198 (23.1 %) had positive RDT and 167 (19.5 %) positive thick films. ASAQ and AL efficacies were 92.7 and 94.2 % before PCR correction, respectively. After genotyping, the overall efficacy was 100 % for ASAQ and 98.0 % for AL.ConclusionThe data reported here represent partially the burden of malaria in 0–11 years old febrile children examined in public health centres of Owando city and serve as reference for further studies. Both artemisinin-based combinations were highly efficacious in patients under 12 years old with acute uncomplicated malaria. ASAQ was associated with more adverse events, which may reduce compliance in unsupervised treatment.Trial registration: ACTRN12612000940875

【 授权许可】

CC BY   
© Singana et al. 2016