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Protocol for a quasi-experimental study to assess the feasibility, acceptability and costs of multiple first-lines artemisinin-based combination therapies for uncomplicated malaria in the Kaya health district, Burkina Faso

February 17, 2021 - 09:25 -- Open Access
Siribie M, Tchouatieu AM, Sirima SB, et al.
BMJ Open. 2021 Feb 15;11(2):e040220

As demonstrated in mathematical models, the simultaneous deployment of multiple first-line therapies (MFT) for uncomplicated malaria, using artemisinin-based combination therapies (ACTs), may extend the useful therapeutic life of the current ACTs. This is possible by reducing drug pressure and slowing the spread of resistance without putting patients' life at risk. We hypothesised that a simultaneous deployment of three different ACTs is feasible, acceptable and can achieve high coverage rate if potential barriers are properly identified and addressed.

Influence of cytochrome P450 (CYP) 2C8 polymorphisms on the efficacy and tolerability of artesunate‐amodiaquine treatment of uncomplicated Plasmodium falciparum malaria in Zanzibar

February 16, 2021 - 15:49 -- Open Access
Leyre Pernaute-Lau, Ulrika Morris, Mwinyi Msellem, Andreas Mårtensson, Anders Björkman and Jose Pedro Gil
Malaria Journal 2021 20:90, 15 February 2021

The anti-malarial drug, amodiaquine, a commonly used, long-acting partner drug in artemisinin-based combination therapy, is metabolized to active desethyl-amodiaquine (DEAQ) by cytochrome P450 2C8 (CYP2C8). The CYP2C8 gene carries several polymorphisms including the more frequent minor alleles, CYP2C8*2 and CYP2C8*3. These minor alleles have been associated with decreased enzymatic activity, slowing the amodiaquine biotransformation towards DEAQ. This study aimed to assess the influence of these CYP2C8 polymorphisms on the efficacy and tolerability of artesunate–amodiaquine (AS–AQ) treatment for uncomplicated Plasmodium falciparum malaria in Zanzibar.

Hepatic safety of repeated treatment with pyronaridine‐artesunate versus artemether–lumefantrine in patients with uncomplicated malaria: a secondary analysis of the WANECAM 1 data from Bobo-Dioulasso, Burkina Faso

February 3, 2021 - 15:08 -- Open Access
Yves Daniel Compaoré, Issaka Zongo, Jean Bosco Ouédraogo, et al.
Malaria Journal 2021 20:64, 29 January 2021

The use of pyronaridine-artesunate (PA) has been associated with scarce transaminitis in patients. This analysis aimed to evaluate the hepatic safety profile of repeated treatment with PA versus artemether–lumefantrine (AL) in patients with consecutive uncomplicated malaria episodes in Bobo-Dioulasso, Burkina Faso.

Severe orthostatic hypotension in otherwise uncomplicated Plasmodium vivax infection

January 13, 2021 - 08:33 -- Open Access
Chaisith Sivakorn, Polrat Wilairatana, Srivicha Krudsood, Marcus J. Schultz, Tachpon Techarang, Khanittha Kheawsawaung and Arjen M. Dondorp
Malaria Journal 2021 20:28, 7 January 2021

Impaired autonomic control of postural homeostasis resulting in orthostatic hypotension has been described in falciparum malaria. However, severe orthostatic intolerance in Plasmodium vivax has been rarely reported.

Efficacy of Artemisinin-lumefantrine for treatment of uncomplicated malaria after more than a decade of its use in Kenya

January 5, 2021 - 14:47 -- Open Access
Kishoyian G, Njagi ENM, Orinda GO, Kimani FT, Thiongo K, Matoke-Muhia D
Epidemiol Infect. 2021 Jan 5:1-24

The  resistance  of Plasmodium  falciparum to  antimalarial  drugs  remains  a  major impairment  in the treatment  and  eradication of malaria globally. Following the introduction of artemisinin-based combination therapy (ACT), there have been reports of delayed parasite clearance. In Kenya, artemether-lumefantrine (AL) is the recommended first-line treatment of uncomplicated malaria. This study sought  to  assess  the  efficacy  of  AL  after  a  decade  of use as the  preferred  method  of  managing  malarial  infections in Kenya. We assessed clinical and parasitological esponses of children under five years between May and November 2015 in Chulaimbo   sub-County,   Kisumu,   Kenya.

Machine learning approaches classify clinical malaria outcomes based on haematological parameters

December 3, 2020 - 13:21 -- Open Access
Morang'a CM, Amenga-Etego L, Bah SY, Appiah V, Amuzu DSY, Amoako N, Abugri J, Oduro AR, Cunnington AJ, Awandare GA, Otto TD
BMC Med. 2020 Nov 30;18(1):375

Malaria is still a major global health burden, with more than 3.2 billion people in 91 countries remaining at risk of the disease. Accurately distinguishing malaria from other diseases, especially uncomplicated malaria (UM) from non-malarial infections (nMI), remains a challenge. Furthermore, the success of rapid diagnostic tests (RDTs) is threatened by Pfhrp2/3 deletions and decreased sensitivity at low parasitaemia. Analysis of haematological indices can be used to support the identification of possible malaria cases for further diagnosis, especially in travellers returning from endemic areas. As a new application for precision medicine, we aimed to evaluate machine learning (ML) approaches that can accurately classify nMI, UM, and severe malaria (SM) using haematological parameters.

Predictors of outcome in childhood Plasmodium falciparum malaria

December 2, 2020 - 09:02 -- Open Access
Patel H, Dunican C, Cunnington AJ
Virulence. 2020 Dec;11(1):199-221

Plasmodium falciparum malaria is classified as either uncomplicated or severe, determining clinical management and providing a framework for understanding pathogenesis. Severe malaria in children is defined by the presence of one or more features associated with adverse outcome, but there is wide variation in the predictive value of these features.

NOT Open Access | Therapeutic Efficacy of Artemether-Lumefantrine for Uncomplicated Falciparum Malaria in Northern Zambia

October 21, 2020 - 09:31 -- NOT Open Access
Ippolito MM, Pringle JC, Thuma PE, et al.
Am J Trop Med Hyg. 2020 Oct 19

Artemether-lumefantrine (AL) is a first-line agent for uncomplicated malaria caused by Plasmodium falciparum. The WHO recommends periodic therapeutic efficacy studies of antimalarial drugs for the detection of malaria parasite drug resistance and to inform national malaria treatment policies. We conducted a therapeutic efficacy study of AL in a high malaria transmission region of northern Zambia from December 2014 to July 2015.

Artenimol–piperaquine in children with uncomplicated imported falciparum malaria: experience from a prospective cohort

December 17, 2019 - 16:36 -- Open Access
Lauren Pull, Jean-Marc Lupoglazoff, Matthew Beardmore, Jean-François Michel, Pierre Buffet, Olivier Bouchaud and Jean-Yves Siriez
Malaria Journal 2019 18:419, 16 December 2019

Although malaria remains one of the major public health threats in inter-tropical areas, there is limited understanding of imported malaria in children by paediatricians and emergency practitioners in non-endemic countries, often resulting in misdiagnosis and inadequate treatment. Moreover, classical treatments (atovaquone-proguanil, quinine, mefloquine) are limited either by lengthy treatment courses or by side effects. Since 2010, the World Health Organization (WHO) has recommended the use of oral artemisinin-based combination therapy for the treatment of uncomplicated Plasmodium falciparum malaria worldwide. The benefits of artenimol–piperaquine in children have been validated in endemic countries but experience remains limited in cases of imported malaria.

Genetic diversity of Plasmodium falciparum isolates from patients with uncomplicated and severe malaria based on msp-1 and msp-2 genes in Gublak, North West Ethiopia

December 17, 2019 - 15:51 -- Open Access
Hussein Mohammed, Kedir Hassen, Ashenafi Assefa, Kalkidan Mekete, Gemechu Tadesse, Girum Taye and Robert J. Commons
Malaria Journal 2019 18:413, 10 December 2019

Malaria infection can present with a wide variety of symptoms, ranging from mild to severe. Plasmodium falciparum isolates in uncomplicated and severe malaria infections may have different parasite genetic profiles. This study was conducted to assess differences in genetic diversity and allelic frequencies in P. falciparum isolates according to malaria severity and age of patients in the Gublack area, northwest Ethiopia.

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