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Surveillance of the Efficacy of Artemisinin-Piperaquine in the Treatment of Uncomplicated Plasmodium falciparum Malaria Among Children Under 5 Years of Age in Est-Mono District, Togo, in 2017.
Wang, Qi; Zhang, Zhenyan; Yu, Weisheng; Lu, Chenguang; Li, Guoming; Pan, Ziyi; Zhang, Hongying; Wu, Wanting; Oubou, Tinah Atcha; Yuan, Yueming; Guo, Jiawen; Liang, Yuan; Huang, Xinan; Guo, Wenfeng; Li, Changqing; Julie, Nadia; Xu, Qin; Sanwogou, Logte; Song, Jianping; Deng, Changsheng.
Afiliação
  • Wang Q; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Zhang Z; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Yu W; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Lu C; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Li G; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Pan Z; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Zhang H; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Wu W; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Oubou TA; Tinah ATCHA OUBOU, National Malaria Control Program, Ministry of Health and Social Security, Lome, Togo.
  • Yuan Y; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Guo J; Institute of Science and Technology, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Liang Y; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Huang X; Institute of Science and Technology, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Guo W; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Li C; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Julie N; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Xu Q; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Sanwogou L; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Song J; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Deng C; Logte SANWOGOU, Health Bureau, East Mono District, Togo.
Front Pharmacol ; 11: 784, 2020.
Article em En | MEDLINE | ID: mdl-32581785
BACKGROUND: Malaria is a major public health concern in Togo. The Est-Mono district of Togo has a population of 150,000. Accordingly, the Guangzhou University of Chinese Medicine, China and the Ministry of Health and Social Security, Togo launched a nationwide Mass Drug Administration Project with artemisinin-piperaquine (AP) in Est-Mono. Before launching this project, the sensitivity test of AP was conducted in a general clinic in Elawagnon, Togo. With this background, we evaluated the efficacy and safety of AP for the treatment of uncomplicated falciparum malaria in children under the age of 5 years. METHODS: Children aged 6-59 months with uncomplicated falciparum malaria were enrolled in this study. The selected patients were treated with a combination regime of artemisinin-piperaquine. The patients were followed up for 28 days, during which signs of the following were observed for: the duration for fever clearance, parasitemia density, gametophyte generation, cure rate, hemoglobin level, and merozoite surface protein-2 (msp-2) polymorphism. The primary end point was a 28-day cure rate and polymerase chain reaction (PCR)-corrected reinfection and recrudescence. This research followed the standardized World Health Organization (WHO) protocol for the assessment of the efficacy of antimalarial drugs. RESULTS: A total of 91 children with uncomplicated falciparum malaria were enrolled in this study. Adequate clinical and parasitological responses (ACPRs) before and after PCR-correction were 66 (73%) and 90 (99%), respectively. The average hemoglobin level in the patient increased by 0.05 g/dl per day (p < 0.0001) after the treatment. The gametophyte generation did not decline at the beginning of the treatment; however, after 14 days, it declined (day 21: p < 0.05; day 28: p < 0.01). In the msp-2 polymorphism study of 24 children treated for parasite infection, one case of msp-2 with 3D7 haplotype and FC27 haplotype was noted, indicating its recrudescence, with a frequency of 4%. The remaining 23 cases could have been of reinfection, with a frequency of 96%. No serious adverse reactions occurred, and AP was well-tolerated by all patients. CONCLUSION: Artemisinin-piperaquine was found to be an effective combination for treating uncomplicated falciparum malaria in children aged <5 years in Togo, and the drugs were well-tolerated. In Togo, Plasmodium falciparum remains sensitive to artemisinin-piperaquine, necessitating its trial in this region. CLINICAL TRIAL REGISTRATION: Trial registration: ECGPHCM No. B2017-054-01; MHSST AVIS N° 0001/2016/CBRS du 07 janvier 2016. Registered 17 March 2014, http://www.chinadrugtrials.org.cn/eap/main.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Guideline / Screening_studies Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Guideline / Screening_studies Idioma: En Ano de publicação: 2020 Tipo de documento: Article