In 2006, Senegal adopted artemisinin-based combination therapy (ACT) as first-line treatment in the management of uncomplicated malaria. This study aimed to update the status of antimalarial efficacy more than ten years after their first introduction. This was a randomized, three-arm, open-label study to evaluate the efficacy and safety of artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ) and dihydroartemisinin-piperaquine (DP) in Senegal. Malaria suspected patients were screened, enrolled, treated, and followed for 28 days for AL and ASAQ arms or 42 days for DP arm. Clinical and parasitological responses were assessed following antimalarial treatment. Genotyping (msp1, msp2 and 24 SNP-based barcode) were done to differentiate recrudescence from re-infection; in case of PCR-confirmed treatment failure, Pfk13 propeller and Pfcoronin genes were sequenced. Data was entered and analyzed using the WHO Excel-based application. A total of 496 patients were enrolled. In Diourbel, PCR non-corrected/corrected adequate clinical and parasitological responses (ACPR) was 100.0% in both the AL and ASAQ arms. In Kedougou, PCR corrected ACPR values were 98.8%, 100% and 97.6% in AL, ASAQ and DP arms respectively. No Pfk13 or Pfcoronin mutations associated with artemisinin resistance were found. This study showed that AL, ASAQ and DP remain efficacious and well-tolerated in the treatment of uncomplicated P. falciparum malaria in Senegal.

译文

:2006年,塞内加尔采用基于青蒿素的联合治疗(ACT)作为一例简单的疟疾治疗方法。这项研究旨在在首次引入抗疟药功效十多年后更新其现状。这是一项随机,三臂,开放标签的研究,用于评估塞内加尔的蒿甲醚-卢美他汀(AL),青蒿琥酯-阿地二喹(ASAQ)和二氢青蒿素-哌喹(DP)的疗效和安全性。对AL和ASAQ组的疟疾疑似患者进行筛查,入组,治疗和随访28天,而DP组则随访42天。抗疟疾治疗后评估临床和寄生虫学反应。进行了基因分型(基于msp1,msp2和24个SNP的条形码)以区分再发与再次感染。如果经PCR确认治疗失败,则对Pfk13螺旋桨和Pfcoronin基因进行测序。使用基于WHO Excel的应用程序输入和分析数据。共有496例患者入组。在Diourbel中,AL和ASAQ组的PCR未校正/校正的足够的临床和寄生虫学应答(ACPR)为100.0%。在Kedougou,AL,ASAQ和DP组经PCR校正的ACPR值分别为98.8%,100%和97.6%。没有发现与青蒿素耐药有关的Pfk13或Pfcoronin突变。这项研究表明,AL,ASAQ和DP在塞内加尔的单纯性恶性疟原虫疟疾治疗中仍然有效且耐受性良好。

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