Short-course artesunate treatment of uncomplicated Plasmodium falciparum malaria in Gabon - PubMed (original) (raw)

Short-course artesunate treatment of uncomplicated Plasmodium falciparum malaria in Gabon

Steffen Borrmann et al. Antimicrob Agents Chemother. 2003 Mar.

Abstract

Artesunate is one of the most important antimalarial agents available, since it is effective against parasites that have developed resistance to conventional antimalarials in sub-Saharan Africa. Antimalarial combination chemotherapies with artesunate (4 mg/kg of body weight once daily for 3 days) as one partner have been proposed. However, the efficacy of a 3-day course of artesunate alone has never been evaluated in individuals in Africa (which has 90% of the worldwide malaria burden) living in regions of hyperendemicity, where a considerable degree of immunity might substantially enhance the efficacy of short courses of artesunate compared to those in regions where the levels of endemicity are low. This lack of information does not permit a systematic assessment of the value of artesunate-based combination chemotherapies in Africa. Therefore, we studied the efficacy and safety of a 3-day course of artesunate (4 mg/kg of body weight, orally, once daily) for the treatment of uncomplicated Plasmodium falciparum malaria in Gabonese patients aged 4 to 15 years (n = 50). Artesunate was well tolerated, and no severe adverse event was reported. Parasite elimination was rapid and was achieved in all patients within < or =72 h (geometric mean time to elimination, 34 h). The PCR-corrected cure rate by day 14 was 92% (46 of 50 patients), but it dropped to 72% (36 of 50 patients) by day 28. We conclude that a 3-day course of artesunate fails to achieve sufficiently high cure rates for uncomplicated falciparum malaria in Gabonese children.

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References

    1. Adjuik, M., P. Agnamey, A. Babiker, S. Borrmann, P. Brasseur, M. Cisse, F. Cobelens, S. Diallo, J. F. Faucher, P. Garner, S. Gikunda, P. G. Kremsner, S. Krishna, B. Lell, M. Loolpapit, P.- B. Matsiegui, M. A. Missinou, J. Mwanza, F. Ntoumi, P. Olliaro, P. Osimbo, P. Rezbach, E. Some, and W. R. Taylor. 2002. Amodiaquine-artesunate versus amodiaquine for uncomplicated Plasmodium falciparum malaria in African children: a randomised, multicentre trial. Lancet 359:1365-1372. - PubMed
    1. Alin, M. H., C. M. Kihamia, A. Bjorkman, B. A. Bwijo, Z. Premji, G. J. Mtey, and M. Ashton. 1995. Efficacy of oral and intravenous artesunate in male Tanzanian adults with Plasmodium falciparum malaria and in vitro susceptibility to artemisinin, chloroquine, and mefloquine. Am. J. Trop. Med. Hyg. 53:639-645. - PubMed
    1. Basco, L. K., J. Bickii, and P. Ringwald. 1998. In vitro activity of lumefantrine (benflumetol) against clinical isolates of Plasmodium falciparum in Yaounde, Cameroon. Antimicrob. Agents Chemother. 42:2347-2351. - PMC - PubMed
    1. Brockman, A., R. N. Price, M. van Vugt, D. G. Heppner, D. Walsh, P. Sookto, T. Wimonwattrawatee, S. Looareesuwan, N. J. White, and F. Nosten. 2000. Plasmodium falciparum antimalarial drug susceptibility on the north-western border of Thailand during five years of extensive use of artesunate-mefloquine. Trans. R. Soc. Trop. Med. Hyg. 94:537-544. - PMC - PubMed
    1. Bunnag, D., C. Viravan, S. Looareesuwan, J. Karbwang, and T. Harinasuta. 1991. Clinical trial of artesunate and artemether on multidrug resistant falciparum malaria in Thailand. A preliminary report. Southeast Asian J. Trop. Med. Public Health 22:380-385. - PubMed

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