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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Therapeutic efficacy of fixed dose artesunate-mefloquine for the treatment of acute, uncomplicated Plasmodium falciparum malaria in Kampong Speu, Cambodia
Malaria Journal, Volume 12, No. 1, Article 343, Year 2013
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Description
Background: Cambodia stopped using co-blistered, non-fixed, artesunate-mefloquine (ASMQ) in 2008 when treatment failure rates approximated 20%. Fixed dose combination (FDC) ASMQ is efficacious against acute uncomplicated, drug resistant Plasmodium falciparum malaria in Southeast Asia but has not been tested in Cambodia. Methods. A 42-day WHO therapeutic efficacy study (TES) was conducted in 2010 in Oral, Kampong Speu province, south-west Cambodia, in patients with acute uncomplicated P. falciparum. Daily administered FDC ASMQ for three days was dosed by age. Genotyping of isolates at day 0 and day of recrudescence by polymerase chain reaction (PCR) classified post-treatment recurrent falciparum parasitaemia. Ex vivo drug sensitivity testing ([3H] hypoxanthine method) was performed on baseline parasites and reported as the drug concentration inhibiting 50% parasite growth vs no drug (IC50). Results: Recruited patients numbered 45; five aged <15 years. On day 3, five of 45 [11.1 (3.7-24.05)] % patients were still parasite-positive; one of whom later failed treatment on day 21. There were 5/45 (11.1%) late treatment failures on day 21, 28 and 35; all were PCR diagnosed recrudescent infections. The day 0 MQ IC50s ranged from 11.5-238.9 (median 58.6) nM. Conclusions: This TES demonstrated reasonable efficacy in an area of possible reduced artemisinin sensitivity and high MQ IC50s. Efficacy testing of FDC ASMQ should continue in Cambodia and be considered for reintroduction if efficacy returns. © 2013 Leang et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Leang, Rithea
Cambodia, Phnom Penh
National Centre for Parasitology, Entomology and Malaria Control
Socheat, Duong
Cambodia, Phnom Penh
National Centre for Parasitology, Entomology and Malaria Control
Navaratnam, Visweswaran
Unknown Affiliation
Lim, Pharath
Cambodia, Phnom Penh
National Centre for Parasitology, Entomology and Malaria Control
Ariey, Frédéric
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Kiechel, Jean René
Switzerland, Geneve
Drugs for Neglected Diseases Initiative
Menard, Didier
Cambodia, Phnom Penh
Institut Pasteur du Cambodge
Taylor, Walter R.J.
Cambodia, Phnom Penh
National Centre for Parasitology, Entomology and Malaria Control
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Statistics
Citations: 13
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1186/1475-2875-12-343
ISSN:
14752875
Research Areas
Health System And Policy
Infectious Diseases