Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018
Abstract Background The World Health Organization recommends regularly assessing the efficacy of artemisinin-based combination therapy (ACT), which is a critical tool in the fight against malaria. This study evaluated the efficacy of two artemisinin-based combinations recommended to treat uncomplica...
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doaj-2520abf4f39f42a6bea25927979e20492021-01-24T12:43:44ZengBMCMalaria Journal1475-28752021-01-0120111210.1186/s12936-021-03585-6Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018Adama Gansané0Leah F. Moriarty1Didier Ménard2Isidore Yerbanga3Esperance Ouedraogo4Paul Sondo5Rene Kinda6Casimir Tarama7Edwige Soulama8Madou Tapsoba9David Kangoye10Cheick Said Compaore11Ousmane Badolo12Blami Dao13Samuel Tchwenko14Halidou Tinto15Innocent Valea16Centre National de Recherche Et de Formation Sur Le PaludismeDivision of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, US President’s Malaria InitiativeMalaria Genetics and Resistance Unit, Department of Parasites and Insect Vectors, Institut PasteurIRSS / Unité de Recherche Clinique de NanoroCentre National de Recherche Et de Formation Sur Le PaludismeIRSS / Unité de Recherche Clinique de NanoroCentre National de Recherche Et de Formation Sur Le PaludismeCentre National de Recherche Et de Formation Sur Le PaludismeCentre National de Recherche Et de Formation Sur Le PaludismeCentre National de Recherche Et de Formation Sur Le PaludismeCentre National de Recherche Et de Formation Sur Le PaludismeNational Malaria Control ProgrammeJHPIEGO/ Improving Malaria CareJHPIEGO/ Improving Malaria CareDivision of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, US President’s Malaria InitiativeIRSS / Unité de Recherche Clinique de NanoroIRSS / Unité de Recherche Clinique de NanoroAbstract Background The World Health Organization recommends regularly assessing the efficacy of artemisinin-based combination therapy (ACT), which is a critical tool in the fight against malaria. This study evaluated the efficacy of two artemisinin-based combinations recommended to treat uncomplicated Plasmodium falciparum malaria in Burkina Faso in three sites: Niangoloko, Nanoro, and Gourcy. Methods This was a two-arm randomized control trial of the efficacy of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Children aged 6–59 months old were monitored for 42 days. The primary outcomes of the study were uncorrected and PCR-corrected efficacies to day 28 for AL and 42 for DP. Molecular markers of resistance to artemisinin derivatives and partner drugs were also analysed. Results Of 720 children enrolled, 672 reached study endpoints at day 28, 333 in the AL arm and 339 in the DP arm. PCR-corrected 28-day per protocol efficacy in the AL arm was 74% (64–83%) in Nanoro, 76% (66–83%) in Gourcy, and 92% (84–96%) in Niangoloko. The PCR-corrected 42-day per protocol efficacy in the DP arm was 84% (75–89%) in Gourcy, 89% (81–94%) in Nanoro, and 97% (92–99%) in Niangoloko. No Pfk13 mutation previously associated with artemisinin-resistance was observed. No statistically significant association was found between treatment outcome and presence of the 86Y mutation in the Pfmdr1 gene. There was also no association observed between treatment outcome and Pfpm2 or Pfmdr1 copy number variation. Conclusion The results of this study indicate evidence of inadequate efficacy of AL at day 28 and DP at day 42 in the same two sites. A change of first-line ACT may be warranted in Burkina Faso. Trial Registry Pan African Clinical Trial Registry Identifier: PACTR201708002499311. Date of registration: 8/3/2017 https://pactr.samrc.ac.za/Search.aspxhttps://doi.org/10.1186/s12936-021-03585-6Plasmodium falciparumArtemether-lumefantrineDihydroartemisinin-piperaquineEfficacyBurkina fasoAntimalarial |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adama Gansané Leah F. Moriarty Didier Ménard Isidore Yerbanga Esperance Ouedraogo Paul Sondo Rene Kinda Casimir Tarama Edwige Soulama Madou Tapsoba David Kangoye Cheick Said Compaore Ousmane Badolo Blami Dao Samuel Tchwenko Halidou Tinto Innocent Valea |
spellingShingle |
Adama Gansané Leah F. Moriarty Didier Ménard Isidore Yerbanga Esperance Ouedraogo Paul Sondo Rene Kinda Casimir Tarama Edwige Soulama Madou Tapsoba David Kangoye Cheick Said Compaore Ousmane Badolo Blami Dao Samuel Tchwenko Halidou Tinto Innocent Valea Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018 Malaria Journal Plasmodium falciparum Artemether-lumefantrine Dihydroartemisinin-piperaquine Efficacy Burkina faso Antimalarial |
author_facet |
Adama Gansané Leah F. Moriarty Didier Ménard Isidore Yerbanga Esperance Ouedraogo Paul Sondo Rene Kinda Casimir Tarama Edwige Soulama Madou Tapsoba David Kangoye Cheick Said Compaore Ousmane Badolo Blami Dao Samuel Tchwenko Halidou Tinto Innocent Valea |
author_sort |
Adama Gansané |
title |
Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018 |
title_short |
Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018 |
title_full |
Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018 |
title_fullStr |
Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018 |
title_full_unstemmed |
Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017–2018 |
title_sort |
anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in burkina faso, 2017–2018 |
publisher |
BMC |
series |
Malaria Journal |
issn |
1475-2875 |
publishDate |
2021-01-01 |
description |
Abstract Background The World Health Organization recommends regularly assessing the efficacy of artemisinin-based combination therapy (ACT), which is a critical tool in the fight against malaria. This study evaluated the efficacy of two artemisinin-based combinations recommended to treat uncomplicated Plasmodium falciparum malaria in Burkina Faso in three sites: Niangoloko, Nanoro, and Gourcy. Methods This was a two-arm randomized control trial of the efficacy of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Children aged 6–59 months old were monitored for 42 days. The primary outcomes of the study were uncorrected and PCR-corrected efficacies to day 28 for AL and 42 for DP. Molecular markers of resistance to artemisinin derivatives and partner drugs were also analysed. Results Of 720 children enrolled, 672 reached study endpoints at day 28, 333 in the AL arm and 339 in the DP arm. PCR-corrected 28-day per protocol efficacy in the AL arm was 74% (64–83%) in Nanoro, 76% (66–83%) in Gourcy, and 92% (84–96%) in Niangoloko. The PCR-corrected 42-day per protocol efficacy in the DP arm was 84% (75–89%) in Gourcy, 89% (81–94%) in Nanoro, and 97% (92–99%) in Niangoloko. No Pfk13 mutation previously associated with artemisinin-resistance was observed. No statistically significant association was found between treatment outcome and presence of the 86Y mutation in the Pfmdr1 gene. There was also no association observed between treatment outcome and Pfpm2 or Pfmdr1 copy number variation. Conclusion The results of this study indicate evidence of inadequate efficacy of AL at day 28 and DP at day 42 in the same two sites. A change of first-line ACT may be warranted in Burkina Faso. Trial Registry Pan African Clinical Trial Registry Identifier: PACTR201708002499311. Date of registration: 8/3/2017 https://pactr.samrc.ac.za/Search.aspx |
topic |
Plasmodium falciparum Artemether-lumefantrine Dihydroartemisinin-piperaquine Efficacy Burkina faso Antimalarial |
url |
https://doi.org/10.1186/s12936-021-03585-6 |
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