No Evidence of Delayed Parasite Clearance after Oral Artesunate Treatment of Uncomplicated Falciparum Malaria in Mali
No Evidence of Delayed Parasite Clearance after Oral Artesunate Treatment of Uncomplicated Falciparum Malaria in Mali
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DOI：
10.4269/ajtmh.2012.12-0058
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发表时间：
2012-07-01
影响因子：
3.3
通讯作者：
Djimde, Abdoulaye A.
中科院分区：
文献类型：
--
作者：
Maiga, Amelia W.;Fofana, Bakary;Djimde, Abdoulaye A.
东南亚存在恶性疟原虫通过延迟寄生虫清除而对青蒿素产生耐药性。非洲关于青蒿素治疗后寄生虫清除的数据很少，那里的传播率很高，负担也最大，而且青蒿素的使用正在扩大。患有无并发症疟疾的 1-10 岁儿童接受青蒿琥酯治疗 7 天，并随访 28 天。每 8 小时进行一次血涂片检查，直至光学显微镜检查结果呈阴性。结果与 2002-2004 年在同一村庄进行的类似研究进行了比较。聚合酶链反应校正治愈率为100%，与2002-2004年相同。治疗开始后 24 小时，37.0% 的参与者体内寄生虫血症已清除，而 2002-2004 年这一比例为 31.9% (P = 0.5)。中位寄生虫清除时间为 32 小时。只有一名参与者在 48 小时时仍然有寄生虫，并且没有参与者在 72 小时时出现寄生虫血症。青蒿琥酯非常有效，没有证据表明寄生虫清除延迟。我们提供撒哈拉以南非洲地区恶性疟原虫耐药性出现或传播的基线监测数据。
Plasmodium falciparum resistance to artemisinins by delayed parasite clearance is present in Southeast Asia. Scant data on parasite clearance after artemisinins are available from Africa, where transmission is high, burden is greatest, and artemisinin use is being scaled up. Children 1-10 years of age with uncomplicated malaria were treated with 7 days of artesunate and followed for 28 days. Blood smears were done every 8 hours until negative by light microscopy. Results were compared with a similar study conducted in the same village in 2002-2004. The polymerase chain reaction-corrected cure rate was 100%, identical to 2002-2004. By 24 hours after treatment initiation, 37.0% of participants had cleared parasitemia, compared with 31.9% in 2002-2004 (P = 0.5). The median parasite clearance time was 32 hours. Only one participant still had parasites at 48 hours and no participant presented parasitemia at 72 hours. Artesunate was highly efficacious, with no evidence of delayed parasite clearance. We provide baseline surveillance data for the emergence or dissemination of P. falciparum resistance in sub-Saharan Africa.