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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Clinical manifestations of new versus recrudescent malaria infections following anti-malarial drug treatment
Malaria Journal, Volume 11, Article 207, Year 2012
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Description
Background: Distinguishing new from recrudescent infections in post-treatment episodes of malaria is standard in anti-malarial drug efficacy trials. New infections are not considered malaria treatment failures and as a result, the prevention of subsequent episodes of malaria infection is not reported as a study outcome. However, in moderate and high transmission settings, new infections are common and the ability of a short-acting medication to cure an initial infection may be outweighed by its inability to prevent the next imminent infection. The clinical benefit of preventing new infections has never been compared to that of curing the initial infection. Methods. Children enrolled in a sulphadoxine-pyrimethamine efficacy study in Blantyre, Malawi from 1998-2004 were prospectively evaluated. Six neutral microsatellites were used to classify new and recrudescent infections in children aged less than 10years with recurrent malaria infections. Children from the study who did not experience recurrent parasitaemia comprised the baseline group. The odds of fever and anaemia, the rate of haemoglobin recovery and time to recurrence were compared among the groups. Results: Fever and anemia were more common among children with parasitaemia compared to those who remained infection-free throughout the study period. When comparing recrudescent vs. new infections, the incidence of fever was not statistically different. However, children with recrudescent infections had a less robust haematological recovery and also experienced recurrence sooner than those whose infection was classified as new. Conclusions: The results of this study confirm the paramount importance of providing curative treatment for all malaria infections. Although new and recrudescent infections caused febrile illnesses at a similar rate, recurrence due to recrudescent infection did have a worsened haemological outcome than recurrence due to new infections. Local decision-makers should take into account the results of genotyping to distinguish new from recrudescent infections when determining treatment policy on a population level. It is appropriate to weigh recrudescent malaria more heavily than new infection in assessing treatment efficacy. © 2012 Shaukat et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Shaukat, Ayesha M.
United States, Baltimore
University of Maryland School of Medicine
Gilliams, Elizabeth A.
United States, Baltimore
University of Maryland School of Medicine
Kenefic, Leo J.
United States, Baltimore
University of Maryland School of Medicine
Laurens, Matthew B.
United States, Baltimore
University of Maryland School of Medicine
Dzinjalamala, Fraction K.
Malawi, Zomba
University of Malawi
Nyirenda, Osward M.
Malawi, Zomba
University of Malawi
Thesing, Phillip C.
United States, Baltimore
University of Maryland School of Medicine
Malawi, Zomba
University of Malawi
Jacob, Christopher G.
United States, Baltimore
University of Maryland School of Medicine
Molyneux, Malcolm Edward
Malawi, Zomba
University of Malawi
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Taylor, Terrie Ellen
Malawi, Zomba
University of Malawi
United States, East Lansing
Msu College of Osteopathic Medicine
Plowe, Christopher Vv
United States, Baltimore
University of Maryland School of Medicine
Laufer, Miriam K.
United States, Baltimore
University of Maryland School of Medicine
Statistics
Citations: 12
Authors: 12
Affiliations: 4
Identifiers
Doi:
10.1186/1475-2875-11-207
e-ISSN:
14752875
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Malawi