In vivo parasitological measures of artemisinin susceptibility

Hdl Handle:
http://hdl.handle.net/10144/112694
Title:
In vivo parasitological measures of artemisinin susceptibility
Authors:
Stepniewska, Kasia; Ashley, Elizabeth; Lee, Sue J; Anstey, Nicholas; Barnes, Karen I; Binh, Tran Quang; D'Alessandro, Umberto; Day, Nicholas P J; de Vries, Peter J; Dorsey, Grant; Guthmann, Jean-Paul; Mayxay, Mayfong; Newton, Paul N; Olliaro, Piero; Osorio, Lyda; Price, Ric N; Rowland, Mark; Smithuis, Frank; Taylor, Walter R J; Nosten, François; White, Nicholas J
Journal:
The Journal of Infectious Diseases
Abstract:
Parasite clearance data from 18,699 patients with falciparum malaria treated with an artemisinin derivative in areas of low (n=14,539), moderate (n=2077), and high (n=2083) levels of malaria transmission across the world were analyzed to determine the factors that affect clearance rates and identify a simple in vivo screening measure for artemisinin resistance. The main factor affecting parasite clearance time was parasite density on admission. Clearance rates were faster in high-transmission settings and with more effective partner drugs in artemisinin-based combination treatments (ACTs). The result of the malaria blood smear on day 3 (72 h) was a good predictor of subsequent treatment failure and provides a simple screening measure for artemisinin resistance. Artemisinin resistance is highly unlikely if the proportion of patients with parasite densities of <100,000 parasites/microL given the currently recommended 3-day ACT who have a positive smear result on day 3 is <3%; that is, for n patients the observed number with a positive smear result on day 3 does not exceed (n + 60)/24.
Affiliation:
Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Thailand; Menzies School of Health Research and Royal Darwin Hospital, Darwin, Australia; Division of Clinical Pharmacology, Department of Medicine, University
Issue Date:
19-Jan-2010
URI:
http://hdl.handle.net/10144/112694
DOI:
10.1086/650301
PubMed ID:
20085495
Type:
Article
Language:
en
ISSN:
1537-6613
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorStepniewska, Kasiaen
dc.contributor.authorAshley, Elizabethen
dc.contributor.authorLee, Sue Jen
dc.contributor.authorAnstey, Nicholasen
dc.contributor.authorBarnes, Karen Ien
dc.contributor.authorBinh, Tran Quangen
dc.contributor.authorD'Alessandro, Umbertoen
dc.contributor.authorDay, Nicholas P Jen
dc.contributor.authorde Vries, Peter Jen
dc.contributor.authorDorsey, Granten
dc.contributor.authorGuthmann, Jean-Paulen
dc.contributor.authorMayxay, Mayfongen
dc.contributor.authorNewton, Paul Nen
dc.contributor.authorOlliaro, Pieroen
dc.contributor.authorOsorio, Lydaen
dc.contributor.authorPrice, Ric Nen
dc.contributor.authorRowland, Marken
dc.contributor.authorSmithuis, Franken
dc.contributor.authorTaylor, Walter R Jen
dc.contributor.authorNosten, Françoisen
dc.contributor.authorWhite, Nicholas Jen
dc.date.accessioned2010-10-08T14:56:20Z-
dc.date.available2010-10-08T14:56:20Z-
dc.date.issued2010-01-19-
dc.identifier.citationJ Infect Dis 2010;201(4):570-9en
dc.identifier.issn1537-6613-
dc.identifier.pmid20085495-
dc.identifier.doi10.1086/650301-
dc.identifier.urihttp://hdl.handle.net/10144/112694-
dc.description.abstractParasite clearance data from 18,699 patients with falciparum malaria treated with an artemisinin derivative in areas of low (n=14,539), moderate (n=2077), and high (n=2083) levels of malaria transmission across the world were analyzed to determine the factors that affect clearance rates and identify a simple in vivo screening measure for artemisinin resistance. The main factor affecting parasite clearance time was parasite density on admission. Clearance rates were faster in high-transmission settings and with more effective partner drugs in artemisinin-based combination treatments (ACTs). The result of the malaria blood smear on day 3 (72 h) was a good predictor of subsequent treatment failure and provides a simple screening measure for artemisinin resistance. Artemisinin resistance is highly unlikely if the proportion of patients with parasite densities of <100,000 parasites/microL given the currently recommended 3-day ACT who have a positive smear result on day 3 is <3%; that is, for n patients the observed number with a positive smear result on day 3 does not exceed (n + 60)/24.en
dc.language.isoenen
dc.rightsPublished by Infectious Diseases Society of America Archived on this site with permission and copyright 2010 by the Infectious Diseases Society of America, [url]http://www.journals.uchicago.edu/toc/jid[/url]en
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshAntimalarialsen
dc.subject.meshArtemisininsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshDrug Resistanceen
dc.subject.meshEndemic Diseasesen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshKaplan-Meiers Estimateen
dc.subject.meshMalaria, Falciparumen
dc.subject.meshMiddle Ageden
dc.subject.meshParasitemiaen
dc.subject.meshPlasmodium falciparumen
dc.subject.meshRecurrenceen
dc.titleIn vivo parasitological measures of artemisinin susceptibilityen
dc.typeArticleen
dc.contributor.departmentMahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Thailand; Menzies School of Health Research and Royal Darwin Hospital, Darwin, Australia; Division of Clinical Pharmacology, Department of Medicine, Universityen
dc.identifier.journalThe Journal of Infectious Diseasesen

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