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A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya

BACKGROUND: Many countries have implemented artemisinin-based combination therapy (ACT) for the first-line treatment of malaria. Although many studies have been performed on efficacy and tolerability of the combination arthemeter-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP), less is know...

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Autores principales: Mens, Petra F, Sawa, Patrick, van Amsterdam, Sandra M, Versteeg, Inge, Omar, Sabah A, Schallig, Henk DFH, Kager, Piet A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600646/
https://www.ncbi.nlm.nih.gov/pubmed/19017387
http://dx.doi.org/10.1186/1475-2875-7-237
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author Mens, Petra F
Sawa, Patrick
van Amsterdam, Sandra M
Versteeg, Inge
Omar, Sabah A
Schallig, Henk DFH
Kager, Piet A
author_facet Mens, Petra F
Sawa, Patrick
van Amsterdam, Sandra M
Versteeg, Inge
Omar, Sabah A
Schallig, Henk DFH
Kager, Piet A
author_sort Mens, Petra F
collection PubMed
description BACKGROUND: Many countries have implemented artemisinin-based combination therapy (ACT) for the first-line treatment of malaria. Although many studies have been performed on efficacy and tolerability of the combination arthemeter-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP), less is known of the effect of these drugs on gametocyte development, which is an important issue in malaria control. METHODS AND RESULTS: In this two-arm randomized controlled trial, 146 children were treated with either AL or DP. Both groups received directly observed therapy and were followed for 28 days after treatment. Blood samples were analysed with microscopy and NASBA. In comparison with microscopy NASBA detected much more gametocyte positive individuals. Moreover, NASBA showed a significant difference in gametocyte clearance in favour of AL compared to DP. The decline of parasitaemia was slower and persistence or development of gametocytes was significantly higher and longer at day 3, 7 and 14 in the DP group but after 28 days no difference could be observed between both treatment arms. CONCLUSION: Although practical considerations could favour the use of one drug over another, the effect on gametocytogenesis should also be taken into account and studied further using molecular tools like NASBA. This also applies when a new drug is introduced. TRIAL REGISTRATION: Current controlled trials ISRCTN36463274
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spelling pubmed-26006462008-12-12 A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya Mens, Petra F Sawa, Patrick van Amsterdam, Sandra M Versteeg, Inge Omar, Sabah A Schallig, Henk DFH Kager, Piet A Malar J Research BACKGROUND: Many countries have implemented artemisinin-based combination therapy (ACT) for the first-line treatment of malaria. Although many studies have been performed on efficacy and tolerability of the combination arthemeter-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP), less is known of the effect of these drugs on gametocyte development, which is an important issue in malaria control. METHODS AND RESULTS: In this two-arm randomized controlled trial, 146 children were treated with either AL or DP. Both groups received directly observed therapy and were followed for 28 days after treatment. Blood samples were analysed with microscopy and NASBA. In comparison with microscopy NASBA detected much more gametocyte positive individuals. Moreover, NASBA showed a significant difference in gametocyte clearance in favour of AL compared to DP. The decline of parasitaemia was slower and persistence or development of gametocytes was significantly higher and longer at day 3, 7 and 14 in the DP group but after 28 days no difference could be observed between both treatment arms. CONCLUSION: Although practical considerations could favour the use of one drug over another, the effect on gametocytogenesis should also be taken into account and studied further using molecular tools like NASBA. This also applies when a new drug is introduced. TRIAL REGISTRATION: Current controlled trials ISRCTN36463274 BioMed Central 2008-11-18 /pmc/articles/PMC2600646/ /pubmed/19017387 http://dx.doi.org/10.1186/1475-2875-7-237 Text en Copyright © 2008 Mens et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Mens, Petra F
Sawa, Patrick
van Amsterdam, Sandra M
Versteeg, Inge
Omar, Sabah A
Schallig, Henk DFH
Kager, Piet A
A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya
title A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya
title_full A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya
title_fullStr A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya
title_full_unstemmed A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya
title_short A randomized trial to monitor the efficacy and effectiveness by QT-NASBA of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated Plasmodium falciparum malaria in western Kenya
title_sort randomized trial to monitor the efficacy and effectiveness by qt-nasba of artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment and transmission control of uncomplicated plasmodium falciparum malaria in western kenya
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600646/
https://www.ncbi.nlm.nih.gov/pubmed/19017387
http://dx.doi.org/10.1186/1475-2875-7-237
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