TY - JOUR
T1 - West Africa International Centers of Excellence for Malaria Research: drug resistance patterns to artemether-lumefantrine in Senegal, Mali, and The Gambia
AU - Dieye, Baba
AU - Affara, Muna
AU - Sangare, Lassana
AU - Joof, Fatou
AU - Ndiaye, Yaye D.
AU - Gomis, Jules F.
AU - Ndiaye, Mouhamadou
AU - Mbaye, Aminata
AU - Diakite, Mouhamadou
AU - Sy, Ngayo
AU - Mbengue, Babacar
AU - Deme, Awa B.
AU - Daniels, Rachel
AU - Ahouidi, Ambroise D.
AU - Dieye, Tandakha
AU - Abdullahi, Ahmad
AU - Doumbia, Seydou
AU - Ndiaye, Jean L.
AU - Diarra, Ayouba
AU - Ismaela, Abubakar
AU - Coulibaly, Mamadou
AU - Welty, Clint
AU - Ngwa, Alfred Amambua
AU - Shaffer, Jeftley
AU - D'Alessandro, Umberto
AU - Volkman, Sarah K.
AU - Wirth, Dyann F.
AU - Krogstad, Donald J.
AU - Koita, Ousmane
AU - Nwakanma, Davis
AU - Ndiayel, Daouda
N1 - PPU
PY - 2016
Y1 - 2016
N2 - In 2006, artemether lumefantrine (AL) became the first-line treatment of uncomplicated malaria in Senegal, Mali, and the Gambia. To monitor its efficacy, between August 2011 and November 2014, children with uncomplicated Plasmodium falciparum malaria were treated with AL and followed up for 42 days. A total of 463 subjects were enrolled in three sites (246 in Senegal, 97 in Mali, and 120 in Gambia). No early treatment failure was observed and malaria infection cleared in all patients by day 3. Polymerase chain reaction (PCR)-adjusted adequate clinical and parasitological response (ACPR) was 100% in Mali, and the Gambia, and 98.8% in Senegal. However, without PCR adjustment, ACPR was 89.4% overall; 91.5% in Mali, 98.8% in Senegal, and 64.3% in the Gambia (the lower value in the Gambia attributed to poor compliance of the full antimalarial course). However, pfmdrl mutations were prevalent in Senegal and a decrease in parasite sensitivity to artesunate and lumefantrine (as measured by ex vivo drug assay) was observed at all sites. Recrudescent parasites did not show Kelch 13 (K13) mutations and AL remains highly efficacious in these west African sites.
AB - In 2006, artemether lumefantrine (AL) became the first-line treatment of uncomplicated malaria in Senegal, Mali, and the Gambia. To monitor its efficacy, between August 2011 and November 2014, children with uncomplicated Plasmodium falciparum malaria were treated with AL and followed up for 42 days. A total of 463 subjects were enrolled in three sites (246 in Senegal, 97 in Mali, and 120 in Gambia). No early treatment failure was observed and malaria infection cleared in all patients by day 3. Polymerase chain reaction (PCR)-adjusted adequate clinical and parasitological response (ACPR) was 100% in Mali, and the Gambia, and 98.8% in Senegal. However, without PCR adjustment, ACPR was 89.4% overall; 91.5% in Mali, 98.8% in Senegal, and 64.3% in the Gambia (the lower value in the Gambia attributed to poor compliance of the full antimalarial course). However, pfmdrl mutations were prevalent in Senegal and a decrease in parasite sensitivity to artesunate and lumefantrine (as measured by ex vivo drug assay) was observed at all sites. Recrudescent parasites did not show Kelch 13 (K13) mutations and AL remains highly efficacious in these west African sites.
KW - PLASMODIUM-FALCIPARUM MALARIA
KW - DIHYDROARTEMISININ-PIPERAQUINE
KW - CHLOROQUINE SUSCEPTIBILITY
KW - ARTEMISININ RESISTANCE
KW - INCREASED SENSITIVITY
KW - COMBINATION THERAPY
KW - UGANDAN CHILDREN
KW - RANDOMIZED-TRIAL
KW - PFMDR1 GENE
KW - TRANSMISSION
U2 - 10.4269/ajtmh.16-0053
DO - 10.4269/ajtmh.16-0053
M3 - A1: Web of Science-article
SN - 0002-9637
VL - 95
SP - 1054
EP - 1060
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 5
ER -