Efficacies of DHA–PPQ and AS/SP in patients with uncomplicated Plasmodium falciparum malaria in an area of an unstable seasonal transmission in Sudan

Malaria Journal

Research

Abdelmaroof Suliman¹  Nuha S. Elkando²  Fahad Awad Ali Elnour³  Mariam A. Adam³  Abdelrahim O. Mohamed⁴  Elfatih M. Malik⁵  Muzamil M. Abdel Hamid⁶  Omer S. Mohamed⁷ 

[1] Alsalam Health Centre, Damazin, Sudan;Alzohor Health Centre, Damazin, Sudan;Communicable & Non Communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum, Sudan;Department of Biochemistry, Faculty of Medicine, University of Khartoum, Khartoum, Sudan;Neelain Institute for Medical Research, Alneelain University, Khartoum, Sudan;Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan;Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan;Neelain Institute for Medical Research, Alneelain University, Khartoum, Sudan;

关键词: Malaria;    Dihydroartemisinin–piperaquine;    Artesunate;    Sulfadoxine–pyrimethamine;    Sudan;    Genotyping;   

DOI  :  10.1186/s12936-017-1817-9

 received in 2017-03-01, accepted in 2017-04-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundArtemisinin-based combination therapy (ACT), together with other control measures, have reduced the burden of falciparum malaria in sub-Saharan countries, including Sudan. Sudan adopted ACT in 2004 with a remarkable reduction in mortality due to falciparum malaria. However, emergence of resistance to the first-line treatment artesunate and sulfadoxine/pyrimethamine (AS/SP) has created new challenges to the control of malaria in Sudan. A search for an alternative drug of choice for treating uncomplicated malaria has become inevitable. The objective of this study was to evaluate the therapeutic efficacies of dihydroartemisinin/piperaquine (DHA–PPQ) and AS/SP in an area of unstable transmission in Blue Nile State, Sudan in 2015–16.MethodsA total of 148 patients with uncomplicated malaria were recruited in the study from November 2015 to end of January 2016. Seventy-five patients received DHA–PPQ while 73 received AS/SP. Patients were monitored for clinical and parasitological outcomes following the standard WHO protocol for a period of 42 days for DHA–PPQ and 28 days for AS/SP; nested PCR (nPCR) was performed to confirm parasite re-appearance from day 7 onwards.ResultsFifty-five patients completed the DHA–PPQ arm protocol with success cure rate of 98.2% (95% CI 90.3–100%) and one late clinical failure 1.8% (95% CI 0.0–9.7%). The AS/SP showed adequate clinical and parasitological response (ACPR) of 83.6% (95% CI 71.9–91.8%), early treatment failure was 1.6% (95% CI 0.0–8.8%) and late parasitological failure (LPF) was 14.8% (95% CI 7–26.2%). The respective PCR uncorrected LPF was 20%.ConclusionDHA–PPQ is an efficacious ACT and candidate for replacement of first-line treatment in Sudan while AS/SP showed high treatment failure rate and must be replaced.

【 授权许可】

CC BY   
© The Author(s) 2017