West Africa International Centers of Excellence for Malaria Research: drug resistance patterns to artemether-lumefantrine in Senegal, Mali, and The Gambia

Baba Dieye, Muna Affara, Lassana Sangare, Fatou Joof, Yaye D. Ndiaye, Jules F. Gomis, Mouhamadou Ndiaye, Aminata Mbaye, Mouhamadou Diakite, Ngayo Sy, Babacar Mbengue, Awa B. Deme, Rachel Daniels, Ambroise D. Ahouidi, Tandakha Dieye, Ahmad Abdullahi, Seydou Doumbia, Jean L. Ndiaye, Ayouba Diarra, Abubakar IsmaelaMamadou Coulibaly, Clint Welty, Alfred Amambua Ngwa, Jeftley Shaffer, Umberto D'Alessandro, Sarah K. Volkman, Dyann F. Wirth, Donald J. Krogstad, Ousmane Koita, Davis Nwakanma, Daouda Ndiayel

    Research output: Contribution to journalA1: Web of Science-article

    Abstract

    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.

    Original languageEnglish
    JournalAmerican Journal of Tropical Medicine and Hygiene
    Volume95
    Issue number5
    Pages (from-to)1054-1060
    Number of pages7
    ISSN0002-9637
    DOIs
    Publication statusPublished - 2016

    Keywords

    • PLASMODIUM-FALCIPARUM MALARIA
    • DIHYDROARTEMISININ-PIPERAQUINE
    • CHLOROQUINE SUSCEPTIBILITY
    • ARTEMISININ RESISTANCE
    • INCREASED SENSITIVITY
    • COMBINATION THERAPY
    • UGANDAN CHILDREN
    • RANDOMIZED-TRIAL
    • PFMDR1 GENE
    • TRANSMISSION

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