Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania
Abstract Background Diversification of artemisinin-based combination therapy (ACT) is suggested as one of the strategies that can be used to contain artemisinin resistance. Artesunate-amodiaquine (ASAQ) is one of the artemisinin-based combinations that can be used in the diversification strategy as...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
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| Series: | Malaria Journal |
| Online Access: | https://doi.org/10.1186/s12936-024-04923-0 |
| _version_ | 1797233735269089280 |
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| author | Billy Ngasala Samwel Bushukatale Mercy Chiduo Twilumba Makene Lilian Mkony Ally Mohamed Fablizio Molteni Frank Chacky Ritha J. A. Njau Richard Mwaiswelo |
| author_facet | Billy Ngasala Samwel Bushukatale Mercy Chiduo Twilumba Makene Lilian Mkony Ally Mohamed Fablizio Molteni Frank Chacky Ritha J. A. Njau Richard Mwaiswelo |
| author_sort | Billy Ngasala |
| collection | DOAJ |
| description | Abstract Background Diversification of artemisinin-based combination therapy (ACT) is suggested as one of the strategies that can be used to contain artemisinin resistance. Artesunate-amodiaquine (ASAQ) is one of the artemisinin-based combinations that can be used in the diversification strategy as an alternative first-line treatment for uncomplicated malaria in mainland Tanzania. There is however limited data on the efficacy of ASAQ in mainland Tanzania. This study assessed the efficacy of ASAQ for treatment of uncomplicated Plasmodium falciparum malaria in selected sentinel sites for therapeutic efficacy studies in mainland Tanzania. Methods Between December 2018 and March 2020, children aged between 6 months and 10 years, attending at Nagaga, Mkuzi, and Mlimba primary health facilities, and with suspected uncomplicated malaria infection were screened for eligibility to participate in the study. Malaria infection was screened using microscopy. Children with uncomplicated P. falciparum monoinfection and who fulfilled all other inclusion criteria, and had none of the exclusion criteria, according to the World Health Organization (WHO) guidelines, were treated with ASAQ. Follow-up visits were scheduled on days 0, 1, 2, 3, 7, 14, 21, and 28 or on any day of recurrent infection for clinical and laboratory assessment. Polymerase chain reaction (PCR)-corrected cure rate on day 28 was the primary outcome. Results A total of 264 children, 88 in each of the three study sites (Mlimba, Mkuzi and Nagaga health facilities) were enrolled and treated with ASAQ. The ASAQ PCR-corrected cure rate was 100% at all the three study sites. None of the participants had early treatment failure or late clinical failure. Furthermore, none of the participants had a serious adverse event. Conclusion ASAQ was highly efficacious for the treatment of uncomplicated P. falciparum malaria in mainland Tanzania, therefore, it can be deployed as an alternative first-line treatment for uncomplicated malaria as part of diversification strategy to contain the spread of partial artemisinin resistance in the country. |
| first_indexed | 2024-04-24T16:20:53Z |
| format | Article |
| id | doaj.art-3e9b1bf026c3489d888982a549dfda47 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-24T16:20:53Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-3e9b1bf026c3489d888982a549dfda472024-03-31T11:11:16ZengBMCMalaria Journal1475-28752024-03-0123111010.1186/s12936-024-04923-0Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland TanzaniaBilly Ngasala0Samwel Bushukatale1Mercy Chiduo2Twilumba Makene3Lilian Mkony4Ally Mohamed5Fablizio Molteni6Frank Chacky7Ritha J. A. Njau8Richard Mwaiswelo9Department of Medical Parasitology and Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied SciencesDepartment of Medical Parasitology and Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied SciencesNational Institute for Medical Research, Tanga Research CentreDepartment of Medical Parasitology and Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied SciencesDepartment of Medical Parasitology and Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied SciencesNational Malaria Control Program (NMCP), Ministry of HealthNational Malaria Control Program (NMCP), Ministry of HealthNational Malaria Control Program (NMCP), Ministry of HealthDepartment of Medical Parasitology and Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied SciencesDepartment of Microbiology, Immunology, and Parasitology, Faculty of Medicine, Hubert Kairuki Memorial UniversityAbstract Background Diversification of artemisinin-based combination therapy (ACT) is suggested as one of the strategies that can be used to contain artemisinin resistance. Artesunate-amodiaquine (ASAQ) is one of the artemisinin-based combinations that can be used in the diversification strategy as an alternative first-line treatment for uncomplicated malaria in mainland Tanzania. There is however limited data on the efficacy of ASAQ in mainland Tanzania. This study assessed the efficacy of ASAQ for treatment of uncomplicated Plasmodium falciparum malaria in selected sentinel sites for therapeutic efficacy studies in mainland Tanzania. Methods Between December 2018 and March 2020, children aged between 6 months and 10 years, attending at Nagaga, Mkuzi, and Mlimba primary health facilities, and with suspected uncomplicated malaria infection were screened for eligibility to participate in the study. Malaria infection was screened using microscopy. Children with uncomplicated P. falciparum monoinfection and who fulfilled all other inclusion criteria, and had none of the exclusion criteria, according to the World Health Organization (WHO) guidelines, were treated with ASAQ. Follow-up visits were scheduled on days 0, 1, 2, 3, 7, 14, 21, and 28 or on any day of recurrent infection for clinical and laboratory assessment. Polymerase chain reaction (PCR)-corrected cure rate on day 28 was the primary outcome. Results A total of 264 children, 88 in each of the three study sites (Mlimba, Mkuzi and Nagaga health facilities) were enrolled and treated with ASAQ. The ASAQ PCR-corrected cure rate was 100% at all the three study sites. None of the participants had early treatment failure or late clinical failure. Furthermore, none of the participants had a serious adverse event. Conclusion ASAQ was highly efficacious for the treatment of uncomplicated P. falciparum malaria in mainland Tanzania, therefore, it can be deployed as an alternative first-line treatment for uncomplicated malaria as part of diversification strategy to contain the spread of partial artemisinin resistance in the country.https://doi.org/10.1186/s12936-024-04923-0 |
| spellingShingle | Billy Ngasala Samwel Bushukatale Mercy Chiduo Twilumba Makene Lilian Mkony Ally Mohamed Fablizio Molteni Frank Chacky Ritha J. A. Njau Richard Mwaiswelo Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania Malaria Journal |
| title | Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania |
| title_full | Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania |
| title_fullStr | Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania |
| title_full_unstemmed | Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania |
| title_short | Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania |
| title_sort | efficacy of artesunate amodiaquine for treatment of uncomplicated plasmodium falciparum malaria in mainland tanzania |
| url | https://doi.org/10.1186/s12936-024-04923-0 |
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