Therapeutic efficacy trial of artemisinin-based combination therapy for the treatment of uncomplicated malaria and investigation of mutations in k13 propeller domain in Togo, 2012–2013

Malaria Journal

Research

Yao M. Agbo¹  Améyo M. Dorkenoo²  Pascal Ringwald³  Yao Layibo⁴  Degninou Yehadji⁴  Poukpessi Adjeloh⁵  Kossi Yakpa⁵  Fantchè Awokou⁵  Foli Agbeko⁶  Efoe Sossou⁷ 

[1] Faculté des Sciences de la Sante, Université de Lomé, BP 1515, Lomé, Togo;Faculté des Sciences de la Sante, Université de Lomé, BP 1515, Lomé, Togo;Ministere de la Sante et de la Protection Sociale, Angle avenue Sarakawa et avenue du 2 Fevrier, BP 336, Lomé, Togo;Global Malaria Programme, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland;Ministere de la Sante et de la Protection Sociale, Angle avenue Sarakawa et avenue du 2 Fevrier, BP 336, Lomé, Togo;Programme National de Lutte contre le Paludisme, Quartier Administratif, BP 518, Lomé, Togo;Service de Pediatrie, Centre Hospitalier Regional de Sokode, BP 187, Lomé, Togo;Service des Laboratoires, Centre Hospitalier Universitaire Sylvanus Olympio, 198 rue de l’Hopital, Tokoin Hopital, BP 57, Lomé, Togo;

关键词: Artemisinin combination therapy;    Malaria;    Treatment failure;    Togo;    Artemisinin;    Efficacy;    k13;   

DOI  :  10.1186/s12936-016-1381-8

 received in 2016-04-16, accepted in 2016-06-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundSince 2005, the Togo National Malaria Control Programme has recommended two different formulations of artemisinin-based combination therapy (ACT), artesunate–amodiaquine (ASAQ) and artemether-lumefantrine (AL), for the treatment of uncomplicated malaria. Regular efficacy monitoring of these two combinations is conducted every 2 or 3 years. This paper reports the latest efficacy assessment results and the investigation of mutations in the k13 propeller domain.MethodsThe study was conducted in 2012–2013 on three sentinel sites of Togo (Lomé, Sokodé and Niamtougou). Children aged 6–59 months, who were symptomatically infected with Plasmodium falciparum, were treated with either AL (Coartem®, Novartis Pharma, Switzerland) or ASAQ (Co-Arsucam®, Sanofi Aventis, France). The WHO standard protocol for anti-malarial treatment evaluation was used. The primary end-point was 28-day adequate clinical and parasitological response (ACPR), corrected to exclude reinfection using polymerase-chain reaction (PCR) genotyping.ResultsA total of 523 children were included in the study. PCR-corrected ACPR was 96.3–100 % for ASAQ and 97–100 % for AL across the three study sites. Adverse events were negligible: 0–4.8 % across all sites, for both artemisinin-based combinations. Upon investigation of mutations in the k13 propeller domain, only 9 (1.8 %) mutations were reported, three in each site. All mutant parasites were cleared before day 3. All day 3 positive patients were infected with k13 wild type parasites.ConclusionsThe efficacy of AL and ASAQ remains high in Togo, and both drugs are well tolerated. ASAQ and AL would be recommended for the treatment of uncomplicated malaria in Togo.

【 授权许可】

CC BY   
© The Author(s) 2016