Efficacy and safety of artemisinin combination therapy (ACT) for non-falciparum malaria: a systematic review

Malaria Journal

Review

Rosanne W Wieten¹  Michèle van Vugt¹  Daniëlle Kroon²  Benjamin J Visser³  Martin P Grobusch³  Sabine Bélard⁴  Ingeborg M Nagel⁵ 

[1] Department of Infectious Diseases, Division of Internal Medicine, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, PO Box 22700, Meibergdreef 9, 1100, Amsterdam, DE, The Netherlands;Department of Infectious Diseases, Division of Internal Medicine, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, PO Box 22700, Meibergdreef 9, 1100, Amsterdam, DE, The Netherlands;Centre de Recherches de Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon;Department of Infectious Diseases, Division of Internal Medicine, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, PO Box 22700, Meibergdreef 9, 1100, Amsterdam, DE, The Netherlands;Centre de Recherches de Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon;Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany;Department of Infectious Diseases, Division of Internal Medicine, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, PO Box 22700, Meibergdreef 9, 1100, Amsterdam, DE, The Netherlands;Department of Paediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany;Medical Library, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;

关键词: Artemisinin combination therapy;    ACT;    Non-falciparum malaria;    Plasmodium vivax;    Plasmodium ovale;    Plasmodium malariae;    Plasmodium knowlesi;   

DOI  :  10.1186/1475-2875-13-463

 received in 2014-08-29, accepted in 2014-11-18,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundArtemisinin combination therapy (ACT) is recommended as first-line treatment for uncomplicated Plasmodium falciparum malaria, whereas chloroquine is still commonly used for the treatment of non-falciparum species (Plasmodium vivax, Plasmodium ovale and Plasmodium malariae). A more simplified, more uniform treatment approach across all malaria species is worthwhile to be considered both in endemic areas and for malaria as an imported condition alike.MethodsA PROSPERO-registered systematic review to determine the efficacy and safety of ACT for the treatment of non-falciparum malaria was conducted, following PRISMA guidelines. Without language restrictions, Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, Biosis Previews and the African Index Medicus were searched for studies published up to November 2014.ResultsThe literature search identified 986 reports; 40 publications were found eligible for inclusion, all of them on non-falciparum malaria in endemic areas. Most evidence was available for P. vivax (n = 35). Five clinical trials in total were identified evaluating ACT for P. ovale, P. malariae and Plasmodium knowlesi. Most ACT presentations have high efficacy against P. vivax parasites; artemisinin-based combinations have shorter parasite and fever clearance times compared to chloroquine. ACT is as effective as chloroquine in preventing recurrent parasitaemia before day 28. Artemisinin-based combinations with long half-lives show significantly fewer recurrent parasitaemia up to day 63. The limited evidence available supports both the use of chloroquine and an ACT for P. ovale and P. malariae. ACT seems to be preferable for optimal treatment of P. knowlesi.ConclusionACT is at least equivalent to chloroquine in effectively treating non-falciparum malaria. These findings may facilitate development of simplified protocols for treating all forms of malaria with ACT, including returning travellers. Obtaining comprehensive efficacy and safety data on ACT use for non-falciparum species particularly for P. ovale, P. malariae and P. knowlesi should be a research priority.Trial registrationCRD42014009103

【 授权许可】

Unknown   
© Visser et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. 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.