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Therapeutic efficacy and effects of artemisinin-based combination treatments on uncomplicated Plasmodium falciparum malaria-associated anaemia in Nigerian children during seven years of adoption as first-line treatments

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Infectious Diseases of Poverty 2017年第1期6卷 315-334页

作者： Akintunde Sowunmi Kazeem Akano Godwin Ntadom Adejumoke I.Ayede Folasade O.Ibironke Temitope Aderoyeje Elsie O.Adewoye Bayo Fatunmbi Stephen Oguche Henrietta U.Okafor Ismaila Watila Martin Meremikwu Philip Agomo William Ogala Chimere Agomo Onikepe A.Folarin Grace O.Gbotosho Christian T.Happi Department of Pharmacology and Therapeutics University of IbadanIbadanNigeria Institute for Medical Research and Training College of MedicineUniversity of IbadanIbadanNigeria National Malaria Elimination Programme Federal Ministry of HealthAbujaNigeria Department of Paediatrics University of IbadanIbadanNigeria Department of Clinical Pharmacology University College HospitalIbadanNigeria Department of Physiology University of IbadanIbadanNigeria World Health Organization Regional Office for the Western PacificKhan Daun PenhPhnom PenhCambodia Department of Paediatrics University of JosJosNigeria Department of Paediatrics Institute of Child HealthUniversity of Nigeria Teaching HospitalEnuguNigeria Department of Paediatrics Specialist HospitalMaiduguriBorno SateNigeria Department of Paediatrics University of CalabarCalabarCross Rivers StateNigeria Nigeria Institute of Medical Research YabaLagosNigeria Department of Paediatrics Ahmadu Bello UniversityZariaNigeria Department of Biological Sciences Redeemer’s UniversityEdeOsun StateNigeria

Background:Artemisinin-based combination treatments(ACTs)are the first-line treatments of uncomplicated Plasmodium falciparum malaria in many endemic areas but there are few evaluation of their efficacy in anaemic malarious ***:Therapeutic efficacy of 3-day regimens of artesunate-amodiaquine and artemether-lumefantrine was evaluated in 437 anaemic and 909 non-anaemic malarious children following treatment during a seven-year period(2008-2014).Patterns of temporal changes in haematocrit were classified based on haematocrit valueshaematocrit from 30%following treatment were evaluated using a non-compartment ***:PCR-corrected parasitological efficacy 28 days after start of treatment was significantly higher in artesunateamodiaquine-compared to artemether-lumefantrine-treated children[97%(95%CI:92.8-100)versus 96.4%(95%CI:91.3-99.4),P=0.02],but it was similar in non-anaemic and anaemic *** in haematocrit/1000 asexual parasites cleared from peripheral blood was significantly greater at lower compared to higher parasitaemias(Phaematocrit deficits from 30%were monoexponential with mean estimated half-time of 1.4 days(95%CI:1.2-1.6).Anaemia half-time(t_(1/2anaemia))correlated positively with AnRT in the same patients(r=0.69,P<0.0001).Bland-Altman analysis of 10 multiples of t_(1/2anaemia) and AnRT showed narrow limit of agreement with insignificant bias(P=0.07)suggesting both can be used interchangeably in the same ***:Artesunate-amodiaquine and artemether-lumefantrine remain efficacious treatments of uncomplicated *** infections in non-anaemic and anaemic Nigerian children in the last 7 years of adoption as first-line *** ACTs may also

关键词： Malaria-associated anaemia “haematocrit conservation” Artemisinin-based combination treatments Children Nigeria

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