scholarly journals Artemisinin-Based Combination Therapies Are Efficacious and Safe for Treatment of Uncomplicated Malaria in HIV-Infected Ugandan Children

2014 ◽  
Vol 59 (3) ◽  
pp. 446-453 ◽  
Author(s):  
A. Kakuru ◽  
J. Achan ◽  
M. K. Muhindo ◽  
G. Ikilezi ◽  
E. Arinaitwe ◽  
...  
Keyword(s):  
Uncomplicated Malaria ◽  
Combination Therapies

scholarly journals Protocol for a quasi-experimental study to assess the feasibility, acceptability and costs of multiple first-lines artemisinin-based combination therapies for uncomplicated malaria in the Kaya health district, Burkina Faso

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040220
Author(s):  
Mohamadou SIRIBIE ◽  
André-Marie Tchouatieu ◽  
Issiaka Soulama ◽  
Jean Moise Tanga Kaboré ◽  
Yacouba Nombré ◽  
...  
Keyword(s):  
Experimental Study ◽  
Burkina Faso ◽  
Uncomplicated Malaria ◽  
Monitoring And Evaluation ◽  
Health District ◽  
Combination Therapies ◽  
Interrupted Time Series Analysis ◽  
Drug Pressure ◽  
Evaluation Phase ◽  
Quasi Experimental

IntroductionAs demonstrated in mathematical models, the simultaneous deployment of multiple first-line therapies (MFT) for uncomplicated malaria, using artemisinin-based combination therapies (ACTs), may extend the useful therapeutic life of the current ACTs. This is possible by reducing drug pressure and slowing the spread of resistance without putting patients’ life at risk. We hypothesised that a simultaneous deployment of three different ACTs is feasible, acceptable and can achieve high coverage rate if potential barriers are properly identified and addressed.Methods and analysisWe plan to conduct a quasi-experimental study in the Kaya health district in Burkina Faso. We will investigate a simultaneous deployment of three ACTs, artemether–lumefantrine, pyronaridine–artesunate, dihydroartesinin–piperaquine, targeting three segments of the population: pregnant women, children under five and individuals aged five years and above. The study will include four overlapping phases: the formative phase, the MFT deployment phase, the monitoring and evaluation phase and the post-evaluation phase. The formative phase will help generate baseline information and develop MFT deployment tools. It will be followed by the MFT deployment phase in the study area. The monitoring and evaluation phase will be conducted as the deployment of MFT progresses. Cross-sectional surveys including desk reviews as well as qualitative and quantitative research methods will be used to assess the study outcomes. Quantitatives study outcomes will be measured using univariate, bivariate and multivariate analysis, including logistic regression and interrupted time series analysis approach. Content analysis will be performed on the qualitative data.Ethics and disseminationThe Health Research Ethics Committee in Burkina Faso approved the study (Clearance no. 2018-8-113). Study findings will be disseminated through feedback meetings with local communities, national workshops, oral presentations at congresses, seminars and publications in peer-reviewed scientific journals.Trial registration numberNCT04265573.

scholarly journals Artemisinin Combination Therapies for Treatment of Uncomplicated Malaria in Uganda

2006 ◽  
Vol 1 (1) ◽  
pp. e7 ◽  
Author(s):  
Hasifa Bukirwa ◽  
Adoke Yeka ◽  
Moses R Kamya ◽  
Ambrose Talisuna ◽  
Kristin Banek ◽  
...  
Keyword(s):  
Uncomplicated Malaria ◽  
Combination Therapies ◽  
Artemisinin Combination Therapies

scholarly journals Efficacy and safety of artemisinin-based combination therapies for the treatment of uncomplicated malaria in pediatrics: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Workineh Shibeshi ◽  
Getachew Alemkere ◽  
Assefa Mulu ◽  
Ephrem Engidawork
Keyword(s):  
Systematic Review ◽  
Uncomplicated Malaria ◽  
Meta Analysis ◽  
Treatment Success ◽  
Gastrointestinal Symptoms ◽  
Final Analysis ◽  
Malaria Treatment ◽  
Efficacy And Safety ◽  
Combination Therapies ◽  
Intention To Treat

Abstract Background Malaria is a major cause of morbidity and mortality in pediatrics in malaria endemic areas. Artemisinin-based combination therapies (ACTs) are the drugs of choice for malaria management particularly across malaria-endemic countries. This systematic review and meta-analysis was performed to assess efficacy and safety of ACTs for uncomplicated malaria in pediatric populations. Methods A body of evidence was searched for published ACT trials until March 06, 2020. The search was focused on efficacy and safety studies of ACTs for uncomplicated malaria in pediatrics. PubMed library was searched using best adapted search terms after multiple trials. References were exported to the endnote library and then to Covidence for screening. Data was extracted using the Covidence platform. The per-protocol analysis report for the efficacy and the intention-to-treat analysis for the safety were synthesized. Met-analysis was carried using Open Meta-Analyst software. Random effects model was applied and the heterogeneity of studies was evaluated using I2 statistic. Results Nineteen studies were included in the final analysis. Overall, crude, PCR-corrected P. falciparum malaria treatment success rate was 96.3 and 93.9% for day 28 and 42, respectively. In the subgroup analysis, PCR-corrected adequate clinical and parasitological response (ACPR) of dihydroartemisinin-piperaquine (DP) was 99.6% (95% CI: 99.1 to 100%, I2 = 0%; 4 studies) at day 28 and 99.6% (95% CI of 99 to 100%, I2 = 0%; 3 studies) at day 42. Nine studies reported ACT related adverse drug reactions (ADR) (8.3%, 356/4304). The reported drug related adverse reactions ranged from 1.8% in DP (two studies) to 23.3% in artesunate-pyronaridine (AP). Gastrointestinal symptoms were the most common ACT related adverse effects, and all ADRs were reported to resolve spontaneously. Conclusion ACTs demonstrated a high crude efficacy and tolerability against P. falciparum. The high treatment success and tolerability with low heterogeneity conferred by DP has implication for policy makers who plan the use of ACTs for uncomplicated falciparum malaria treatment in pediatrics.

scholarly journals Exploring Barriers and Facilitators of Adherence to Artemisinin-Based Combination Therapies for the Treatment of Uncomplicated Malaria in Children in Freetown, Sierra Leone

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1233
Author(s):  
Kristin Banek ◽  
Deborah D. DiLiberto ◽  
Emily L. Webb ◽  
Samuel Juana Smith ◽  
Daniel Chandramohan ◽  
...  
Keyword(s):  
Health System ◽  
Sierra Leone ◽  
Perceived Risk ◽  
Uncomplicated Malaria ◽  
Health Workers ◽  
Controlled Trial ◽  
Quality Care ◽  
Medication Administration ◽  
Combination Therapies ◽  
Treatment Cascade

Medication adherence is an essential step in the malaria treatment cascade. We conducted a qualitative study embedded within a randomized controlled trial comparing the adherence to the recommended dosing of two artemisinin-based combination therapies (ACT) to treat uncomplicated malaria in Freetown, Sierra Leone. This study explored the circumstances and factors that influenced caregiver adherence to the ACT prescribed for their child in the trial. In-depth interviews were conducted with 49 caregivers; all interviews were recorded, transcribed, and translated. Transcripts were coded and aggregated into themes, applying a thematic content approach. We identified four key factors that influenced optimal treatment adherence: (1) health system influences, (2) health services, (3) caregivers’ experiences with malaria illness and treatment, and (4) medication characteristics. Specifically, caregivers reported confidence in the health system as facilities were well maintained and care was free. They also felt that health workers provided quality care, leading them to trust the health workers and believe the test results. Ease of medication administration and perceived risk of side effects coupled with caregivers’ prior experience treating malaria influenced how medications were administered. To ensure ACTs achieve maximum effectiveness, consideration of these contextual factors and further development of child-friendly antimalarials are needed.

Artemisinin‐based combination therapies for uncomplicated malaria

2005 ◽  
Vol 182 (4) ◽  
pp. 181-185 ◽  
Author(s):  
Timothy M E Davis ◽  
Harin A Karunajeewa ◽  
Kenneth F Ilett
Keyword(s):  
Uncomplicated Malaria ◽  
Combination Therapies

The treatment of imported malaria in children: an update

2012 ◽  
Vol 98 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Karen M Kiang ◽  
Penelope A Bryant ◽  
Delane Shingadia ◽  
Shamez Ladhani ◽  
Andrew C Steer ◽  
...  
Keyword(s):  
Severe Malaria ◽  
Uncomplicated Malaria ◽  
Imported Malaria ◽  
Combination Therapies ◽  
Previous Review ◽  
Adults And Children ◽  
The Uk ◽  
New Evidence

Since the 2010 publication in this journal of a review of the management of imported malaria for UK children, new evidence for the treatment of both severe and uncomplicated malaria has been published. This review discusses these new data and expands the scope of the previous review to include non-endemic countries outside of the UK. The results of the AQUAMAT trial in late 2010 and other studies have prompted the WHO to recommend that intravenous artesunate be used preferentially over quinine for the treatment of severe malaria caused by any Plasmodium species in both adults and children. Oral artemisinin-based combination therapies have also shown equivalent (if not better) efficacy in the treatment of uncomplicated malaria caused by all Plasmodium species (including chloroquine-resistant P vivax) in both adults and children, though there are issues regarding the availability of artemisinin-based combination therapies in many non-endemic countries. In these instances, conventional therapeutic regimens continue to be efficacious. Lastly, the use of primaquine for hypnozoite and gametocyte eradication is discussed.

Efficacy of monotherapies and artesunate-based combination therapies in children with uncomplicated malaria in Somalia

Acta Tropica ◽  
2009 ◽  
Vol 109 (2) ◽  
pp. 146-151 ◽  
Author(s):  
Marian Warsame ◽  
Hoda Atta ◽  
John D. Klena ◽  
Butt Ahmed Waqar ◽  
Hussein Haji Elmi ◽  
...  
Keyword(s):  
Uncomplicated Malaria ◽  
Combination Therapies
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