Trial reportThe American journal of tropical medicine and hygiene2016
No Clinical or Molecular Evidence of Plasmodium falciparum Resistance to Artesunate-Mefloquine in Northwestern Brazil.
Trial report in The American journal of tropical medicine and hygiene, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01144702 (Effectiveness of the Association Artesunate and Mefloquine in the Treatment of Uncomplicated Malaria by Plasmodium Falciparum, Juruá Valley, State of Acre, Brazil, 2009.), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of the Association Artesunate and Mefloquine in the Treatment of Uncomplicated Malaria by Plasmodium Falciparum, Juruá Valley, State of Acre, Brazil, 2009.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- The risk of Plasmodium vivax parasitaemia after P. falciparum malaria: An individual patient data meta-analysis from the WorldWide Antimalarial Resistance Network.PLoS medicine · 2020Pooled it
- Monitoring the Efficacy of Chloroquine-Primaquine Therapy for Uncomplicated Plasmodium vivax Malaria in the Main Transmission Hot Spot of Brazil.Antimicrobial agents and chemotherapy · 2019Trial
- Efficacy of Artemether-Lumefantrine for UncomplicatedThe American journal of tropical medicine and hygiene · 2018Trial
- Hidden Infections, Emerging Resistance: Underdiagnosed Plasmodium vivax and Multidrug Resistance-1 (pvmdr1) Gene Amplification in the Guiana Shield.The Journal of infectious diseases · 2026Article
- Temporal Patterns of Haplotypic and Allelic Diversity Reflect the Changing Selection Landscape of the Malaria Parasite Plasmodium falciparum.Molecular biology and evolution · 2025Article
- Impact of piperaquine resistance in Plasmodium falciparum on malaria treatment effectiveness in The Guianas: a descriptive epidemiological study.The Lancet. Infectious diseases · 2024Article
- Evidence-Based Malaria Control and Elimination in the Amazon: Input from the International Center of Excellence in Malaria Research Network in Peru and Brazil.The American journal of tropical medicine and hygiene · 2022Review
- High-throughputeLife · 2022Article
- Kelch13 mutations in Plasmodium falciparum and risk of spreading in Amazon basin countries.The Journal of antimicrobial chemotherapy · 2021Article
- Molecular Surveillance for Polymorphisms Associated with Artemisinin-Based Combination Therapy Resistance inThe American journal of tropical medicine and hygiene · 2020Article
- Genotypes and phenotypes of resistance in Ecuadorian Plasmodium falciparum.Malaria journal · 2019Article
- Overview of artemisinin effectiveness during outset years of its implementation in the western Brazilian Amazon.Memorias do Instituto Oswaldo Cruz · 2019Article
- Artemisinin Resistance Outside of Southeast Asia.The American journal of tropical medicine and hygiene · 2018Article
- Absence ofThe American journal of tropical medicine and hygiene · 2018Article
- Pharmacokinetics of mefloquine administered with artesunate in patients with uncomplicated falciparum malaria from the Brazilian Amazon basin.Malaria journal · 2018Article
- Article
- Malaria in Brazil, Colombia, Peru and Venezuela: current challenges in malaria control and elimination.Malaria journal · 2017Review
- Plasmodium vivax Landscape in Brazil: Scenario and Challenges.The American journal of tropical medicine and hygiene · 2016Article
- Challenges for malaria elimination in Brazil.Malaria journal · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We evaluated the clinical efficacy of artesunate-mefloquine (ASMQ) fixed-dose combination to treat uncomplicated malaria in Juruá Valley, the main Plasmodium falciparum transmission hotspot in Brazil. Between November 2010 and February 2013, we enrolled 162 patients aged 4-73 years, with fever or a history of fever, and a single-species P. falciparum infection confirmed by microscopy and polymerase chain reaction (PCR). All 154 patients who completed the 42-day follow-up presented an adequate clinical and parasitologic response. ASMQ was well tolerated and no adverse event caused treatment interruption. Gametocytes were detected in 46.3% patients; 35.2% had gametocytes at enrollment, whereas others developed patent gametocytemia 1-14 days after starting ASMQ. By day 3 of treatment, all subjects had cleared asexual parasitemia, but parasite DNA remained PCR detectable in 37.6% of them. Day-3 PCR positivity was associated with prolonged gametocyte carriage. We found no molecular evidence of resistance to either MQ (pfmdr1 gene amplification) or AS (mutations in selected kelch13 gene domains known to be associated with AS resistance) in the local P. falciparum population. These results strongly support the use of ASMQ as a first-line regimen to treat uncomplicated P. falciparum malaria in northwestern Brazil, but underscore the need for gametocytocidal drugs to reduce the transmission potential of ASMQ-treated patients (ClinicalTrials.gov number NCT01144702).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.