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falciparum malaria

Cardiovascular safety and population pharmacokinetic properties of piperaquine in African patients with uncomplicated falciparum malaria - a pooled multicentre analysis

April 23, 2020 - 09:50 -- Open Access
Author(s): 
Wattanakul T, Ogutu B, Tarning J, et al.
Reference: 
Antimicrob Agents Chemother. 2020 Apr 20. pii: AAC.01848-19

Dihydroartemisinin-piperaquine has shown excellent efficacy and tolerability in malaria treatment. However, concerns have been raised of potentially harmful cardiotoxic effects associated with piperaquine. The population pharmacokinetics and cardiac effects of piperaquine were evaluated in 1,000 patients, mostly children enrolled in a multicentre trial from 10 sites in Africa.

Why is WHO failing women with falciparum malaria in the first trimester of pregnancy?

March 17, 2020 - 12:53 -- Open Access
Author(s): 
McGready R, Nosten F, Barnes KI, Mokuolu O, White NJ
Reference: 
Lancet. 2020 Mar 7;395(10226):779

In the opening to WHO's World Malaria Report 2019, subtitled Leaving no one behind in the march to a malaria-free world, WHO's Director-General Tedros Adhanom Ghebreyesus noted that the scourge of malaria continues to strike hardest against pregnant women and children in Africa. The Director-General reported that “some 11 million pregnant women in sub-Saharan Africa were infected with malaria and, consequently, nearly 900 000 children were born with a low birthweight”. Furthermore, he noted that “Malaria in pregnancy compromises the mother's health and puts her at greater risk of death. It impacts the health of the fetus, leading to prematurity and low birthweight, major contributors to neonatal and infant mortality.”

Concomitant bacteremia in adults with severe falciparum malaria

March 3, 2020 - 13:11 -- Open Access
Author(s): 
Phu NH, Day NPJ, White NJ, et al.
Reference: 
Clin Infect Dis. 2020 Feb 28. pii: ciaa191

Approximately 6% of children hospitalised with severe falciparum malaria in Africa are also bacteremic. It is therefore recommended that all children with severe malaria should receive broad spectrum antibiotics in addition to parenteral artesunate. Empirical antibiotics are not recommended currently for adults with severe malaria.

Detection of mutations associated with artemisinin resistance at k13-propeller gene and a near complete return of chloroquine susceptible falciparum malaria in Southeast of Tanzania

March 3, 2020 - 12:39 -- Open Access
Author(s): 
Bwire GM, Ngasala B, Mikomangwa WP, Kilonzi M, Kamuhabwa AAR
Reference: 
Sci Rep. 2020 Feb 26;10(1):3500

In Tanzania, chloroquine was replaced by sulphadoxine- pyrimethamine (SP) as a first-line for treatment of uncomplicated malaria. Due to high resistance in malaria parasites, SP lasted for only 5 years and by the end of 2006 it was replaced with the current artemisinin combination therapy. We therefore, set a study to determine the current genotypic mutations associated with Plasmodium falciparum resistance to artemisinin, partner drugs and chloroquine.

Plasma parasitemia as assessed by quantitative PCR in relation to clinical disease severity in African adults with falciparum malaria with and without HIV co-infection

February 25, 2020 - 16:17 -- Open Access
Author(s): 
Berg A, Patel S, Tellevik MG, Haanshuus CG, Dalen I, Otterdal K, Ueland T, Moyo SJ, Aukrust P, Langeland N
Reference: 
Infection. 2020 Feb 19

When considering malaria disease severity, estimation of parasitemia in erythrocytes is important, but sometimes misleading, since the infected erythrocytes may be sequestered in peripheral capillaries. In African children and Asian adults with falciparum malaria, parasitemia as assessed by quantitative PCR (qPCR) in plasma seems to be a valuable indicator of disease severity, but data on African adults as well as the impact of co-infection with HIV is lacking.

Efficacy of antimalarial drugs for treatment of uncomplicated falciparum malaria in Asian region: A network meta-analysis

December 23, 2019 - 16:09 -- Open Access
Author(s): 
Naing C, Whittaker MA, Htet NH, Aye SN, Mak JW
Reference: 
PLoS ONE 14(12): e0225882

The WHO recommends artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated falciparum malaria. Hence, monitoring the efficacy of antimalarial drugs is a key component of malaria control and elimination. The published randomized trials that assessed comparisons of ACTs for treating uncomplicated falciparum malaria reported conflicting results in treatment efficacy. A network meta-analysis is an extension of pairwise meta-analysis that can synthesize evidence simultaneously from both direct and indirect treatment comparisons. The objective was to synthesize evidence on the comparative efficacy of antimalarial drugs for treatment of uncomplicated falciparum malaria in Asian region.

NOT Open Access | Association of lipid levels with mefloquine and carboxy-mefloquine concentrations in patients with uncomplicated falciparum malaria

December 23, 2019 - 15:12 -- NOT Open Access
Author(s): 
Vieira JLF, Rivera JGB, de Sena LWP, Ferreira MVD
Reference: 
Antimicrob Agents Chemother. 2019 Dec 16. pii: AAC.01731-19

Mefloquine shows a high capacity to bind plasma proteins, which influences the amount of drug in erythrocytes. The study investigated the association of lipids levels with plasma concentrations of mefloquine and carboxy-mefloquine in 85 Brazilian patients with uncomplicated falciparum malaria.

Investigating causal pathways in severe falciparum malaria: A pooled retrospective analysis of clinical studies

September 9, 2019 - 16:47 -- Open Access
Author(s): 
Stije J. Leopold, James A. Watson, Atthanee Jeeyapant, Julie A. Simpson, Nguyen H. Phu, Tran T. Hien, Nicholas P. J. Day, Arjen M. Dondorp, Nicholas J. White
Reference: 
PLoS Med 16(8): e1002858

Severe falciparum malaria is a medical emergency characterised by potentially lethal vital organ dysfunction. Patient fatality rates even with parenteral artesunate treatment remain high. Despite considerable research into adjuvant therapies targeting organ and tissue dysfunction, none have shown efficacy apart from renal replacement therapy. Understanding the causal contributions of clinical and laboratory abnormalities to mortality is essential for the design and evaluation of novel therapeutic interventions.

High therapeutic efficacy of artemether–lumefantrine and dihydroartemisinin–piperaquine for the treatment of uncomplicated falciparum malaria in Somalia

July 12, 2019 - 16:32 -- Open Access
Author(s): 
Marian Warsame, Abdillahi Mohamed Hassan, Pascal Ringwald, et al.
Reference: 
Malaria Journal 2019 18:231, 11 July 2019

Artemether–lumefantrine (AL) and dihydroartemisinin–piperaquine (DHA/PPQ) are the recommended first- and second-line treatments, respectively, for uncomplicated falciparum malaria in Somalia. The studies reported here were conducted to assess the efficacy of these artemisinin-based combinations and the mutations in Plasmodium falciparum K13-propeller (Pfk13) domain and amplification in Pfplasmepsin 2 (Pfpm2) gene in Somalia.

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Population pharmacokinetics and pharmacodynamics of the artesunate–mefloquine fixed dose combination for the treatment of uncomplicated falciparum malaria in African children

April 22, 2019 - 12:28 -- Open Access
Author(s): 
Monia Guidi, Thomas Mercier, Manel Aouri, Laurent A. Decosterd, Chantal Csajka, Bernhards Ogutu, Gwénaëlle Carn and Jean-René Kiechel
Reference: 
Malaria Journal 2019 18:139, 18 April 2019

The population pharmacokinetic models developed for both AS/DHA and MQ showed a large variability in drug exposure in the investigated African paediatric population.

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