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1.
Am J Ther ; 19(4): e122-31, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21519221

RESUMEN

A new dose regimen of artesunate and amodiaquine (NDRAA) based on age or body weight range was compared with standard dose regimen of artesunate and amodiaquine (SDRAA) calculated according to body weight and with fixed-dose artesunate-amodiaquine (FDAA) and artemether-lumefantrine (AL) in 304 children afflicted by malaria aged 15 years or younger. In initial comparison (n = 208), children on NDRAA received 1-3 times amodiaquine per kilogram of body weight and 1-1.5 times of artesunate per kilogram of body weight compared with those receiving SDRAA. Parasite but not fever clearance was significantly faster in children who received NDRAA (19.4 ± 8.4 hours vs. 24.6 ± 15.5 hours, P = 0.003). Polymerase chain reaction-uncorrected cure rates on days 28-42 were also significantly higher in children who received NDRAA (P < 0.02 in all cases). Therapeutic responses in children younger than 5 years (n = 96) treated with NDRAA, FDAA, and AL were similar. Changes in hematocrit values and reported adverse events after commencing therapy were similar in those who received NDRAA and SDRAA. All drug regimens were well tolerated. NDRAA based on age or body weight range is simple, is therapeutically superior to SDRAA calculated according to body weight, and is as efficacious as AL in children younger than 5 years.


Asunto(s)
Amodiaquina/uso terapéutico , Artemisininas/uso terapéutico , Etanolaminas/uso terapéutico , Fluorenos/uso terapéutico , Malaria Falciparum/tratamiento farmacológico , Administración Oral , Adolescente , Factores de Edad , Amodiaquina/administración & dosificación , Amodiaquina/efectos adversos , Antimaláricos/administración & dosificación , Antimaláricos/efectos adversos , Antimaláricos/uso terapéutico , Combinación Arteméter y Lumefantrina , Artemisininas/administración & dosificación , Artemisininas/efectos adversos , Peso Corporal , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Combinación de Medicamentos , Etanolaminas/administración & dosificación , Etanolaminas/efectos adversos , Fluorenos/administración & dosificación , Fluorenos/efectos adversos , Estudios de Seguimiento , Humanos , Lactante , Reacción en Cadena de la Polimerasa , Resultado del Tratamiento
2.
Sci Rep ; 8(1): 5939, 2018 04 12.
Artículo en Inglés | MEDLINE | ID: mdl-29651117

RESUMEN

Lassa fever, a hemorrhagic fever caused by Lassa virus (LASV), is endemic in West Africa. It is difficult to distinguish febrile illnesses that are common in West Africa from Lassa fever based solely on a patient's clinical presentation. The field performance of recombinant antigen-based Lassa fever immunoassays was compared to that of quantitative polymerase chain assays (qPCRs) using samples from subjects meeting the case definition of Lassa fever presenting to Kenema Government Hospital in Sierra Leone. The recombinant Lassa virus (ReLASV) enzyme-linked immunosorbant assay (ELISA) for detection of viral antigen in blood performed with 95% sensitivity and 97% specificity using a diagnostic standard that combined results of the immunoassays and qPCR. The ReLASV rapid diagnostic test (RDT), a lateral flow immunoassay based on paired monoclonal antibodies to the Josiah strain of LASV (lineage IV), performed with 90% sensitivity and 100% specificity. ReLASV immunoassays performed better than the most robust qPCR currently available, which had 82% sensitivity and 95% specificity. The performance characteristics of recombinant antigen-based Lassa virus immunoassays indicate that they can aid in the diagnosis of LASV Infection and inform the clinical management of Lassa fever patients.


Asunto(s)
Anticuerpos Antivirales/inmunología , Antígenos Virales/aislamiento & purificación , Fiebre de Lassa/diagnóstico , Virus Lassa/aislamiento & purificación , África Occidental , Anticuerpos Antivirales/genética , Antígenos Virales/genética , Humanos , Inmunoensayo/métodos , Inmunoglobulina M/inmunología , Fiebre de Lassa/inmunología , Fiebre de Lassa/virología , Virus Lassa/inmunología , Virus Lassa/patogenicidad , Proteínas Recombinantes/genética , Proteínas Recombinantes/inmunología , Sierra Leona , Estudios de Validación como Asunto
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