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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Reduction of malaria transmission to Anopheles mosquitoes with a six-dose regimen of co-artemether
PLoS Medicine, Volume 2, No. 4, Article e92, Year 2005
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Description
Background: Resistance of malaria parasites to chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) is increasing in prevalence in Africa. Combination therapy can both improve treatment and provide important public health benefits if it curbs the spread of parasites harbouring resistance genes. Thus, drug combinations must be identified which minimise gametocyte emergence in treated cases, and so prevent selective transmission of parasites resistant to any of the partner drugs. Methods and Findings: In a randomised controlled trial, 497 children with uncomplicated falciparum malaria were treated with CQ and SP (three doses and one dose respectively; n = 91), or six doses of artemether in fixed combination with lumefantrine (co-artemether [Coartem, Riamet]) (n = 406). Carriage rates of Plasmodium falciparum gametocytes and trophozoites were measured 7, 14, and 28 d after treatment. The infectiousness of venous blood from 29 children carrying P. falciparum gametocytes 7 d after treatment was tested by membrane-feeding of Anopheles mosquitoes. Children treated with co-artemether were significantly less likely to carry gametocytes within the 4 weeks following treatment than those receiving CQ/SP (30 of 378 [7.94%] versus 42 of 86 [48.8%]; p < 0.0001). Carriers in the co-artemether group harboured gametocytes at significantly lower densities, for shorter periods (0.3 d versus 4.2 d; p < 0.0001) and were less infectious to mosquitoes at day 7 (p < 0.001) than carriers who had received CQ/SP. Conclusions: Co-artemether is highly effective at preventing post-treatment transmission of P. falciparum. Our results suggest that co-artemether has specific activity against immature sequestered gametocytes, and has the capacity to minimise transmission of drug-resistant parasites. Copyright: © 2005 Sutherland.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC1087200/bin/pmed.0020092.sd001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC1087200/bin/pmed.0020092.sd002.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC1087200/bin/pmed.0020092.st001.doc
Authors & Co-Authors
Sutherland, Colin J.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Ord, Rosalynn Louise
United Kingdom, London
London School of Hygiene & Tropical Medicine
Dunyo, Samuel K.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Jawara, Musa
United Kingdom, London
London School of Hygiene & Tropical Medicine
Drakeley, Chris J.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Alexander, Neal Douglas Edward
United Kingdom, London
London School of Hygiene & Tropical Medicine
Coleman, Rosalind L.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Pinder, Margaret
United Kingdom, London
London School of Hygiene & Tropical Medicine
Walraven, Gijs E.L.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Targett, Geoffrey A.T.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Statistics
Citations: 149
Authors: 10
Affiliations: 1
Identifiers
Doi:
10.1371/journal.pmed.0020092
ISSN:
15491676
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study