In Vivo Parasitological Measures of Artemisinin Susceptibility

被引：128

作者：

Stepniewska, Kasia ^{[1
,8
]}

Ashley, Elizabeth ^{[1
,2
,8
]}

Lee, Sue J. ^{[1
,8
]}

Anstey, Nicholas ^{[3
,4
]}

Barnes, Karen I. ^{[5
]}

Tran Quang Binh ^{[6
]}

D'Alessandro, Umberto ^{[7
]}

Day, Nicholas P. J. ^{[1
,8
]}

de Vries, Peter J. ^{[10
]}

Dorsey, Grant ^{[11
,12
,13
]}

Guthmann, Jean-Paul ^{[14
,15
]}

Mayxay, Mayfong ^{[16
,17
]}

Newton, Paul N. ^{[17
]}

Olliaro, Piero ^{[8
,18
]}

Osorio, Lyda ^{[20
]}

Price, Ric N. ^{[3
,4
,8
]}

Rowland, Mark ^{[9
]}

Smithuis, Frank

Taylor, Walter R. J. ^{[18
,19
]}

Nosten, Francois ^{[1
,2
,8
]}

White, Nicholas J. ^{[1
,8
]}

机构：

[1] Mahidol Univ, Mahidol Oxford Trop Med Res Unit, Bangkok 10400, Thailand

[2] Shoklo Malaria Res Unit, Mae Sot, Thailand

[3] Menzies Sch Hlth Res, Darwin, NT, Australia

[4] Royal Darwin Hosp, Darwin, NT, Australia

[5] Univ Cape Town, Dept Med, Div Clin Pharmacol, ZA-7925 Cape Town, South Africa

[6] Cho Ray Hosp, Ho Chi Minh City, Vietnam

[7] Inst Trop Med, B-2000 Antwerp, Belgium

[8] Univ Oxford, Ctr Trop Med, Oxford, England

[9] London Sch Hyg & Trop Med, London WC1, England

[10] Univ Amsterdam, Acad Med Ctr, Div Infect Dis Trop Med & AIDS, NL-1105 AZ Amsterdam, Netherlands

[11] Univ Calif San Francisco, San Francisco, CA 94143 USA

[12] Inst Rech Sci Sante, Bobo Dioulasso, Burkina Faso

[13] Uganda Malaria Surveillance Programme, Kampala, Uganda

[14] Epicentre, Paris, France

[15] Inst Veille Sanitaire, Paris, France

[16] Natl Univ Laos, Viangchan, Laos

[17] Univ Oxford, Wellcome Trust Mahosot Hosp, Trop Med Res Collaborat, Microbiol Lab,Mahost Hosp, Viangchan, Laos

[18] World Hlth Org Special Programme Res & Training T, Geneva, Switzerland

[19] Hop Cantonal Univ Geneva, Serv Med Int & Humanitaire, Geneva, Switzerland

[20] Ctr Int Entrenamiento & Invest Med, Cali, Colombia

来源：

JOURNAL OF INFECTIOUS DISEASES | 2010年 / 201卷 / 04期

基金：

英国惠康基金;

关键词：

PLASMODIUM-FALCIPARUM MALARIA; ARTESUNATE-MEFLOQUINE COMBINATION; ANTIMALARIAL-DRUGS; PHARMACODYNAMIC PROPERTIES; PARASITE CLEARANCE; RESISTANT MALARIA; THAILAND; EFFICACY; CAMBODIA; BORDER;

D O I：

10.1086/650301

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Parasite clearance data from 18,699 patients with falciparum malaria treated with an artemisinin derivative in areas of low (n = 14,539), moderate (n = 2077), and high (n = 2083) levels of malaria transmission across the world were analyzed to determine the factors that affect clearance rates and identify a simple in vivo screening measure for artemisinin resistance. The main factor affecting parasite clearance time was parasite density on admission. Clearance rates were faster in high-transmission settings and with more effective partner drugs in artemisinin-based combination treatments (ACTs). The result of the malaria blood smear on day 3 (72 h) was a good predictor of subsequent treatment failure and provides a simple screening measure for artemisinin resistance. Artemisinin resistance is highly unlikely if the proportion of patients with parasite densities of <100,000 parasites/mu L given the currently recommended 3-day ACT who have a positive smear result on day 3 is <3%; that is, for n patients the observed number with a positive smear result on day 3 does not exceed. (n + 60)/24.

引用

页码：570 / 579

页数：10

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