Evidence map›Paper›PMID 27280792›Full record

Trial reportPloS one2016

Uncomplicated Clinical Malaria Features, the Efficacy of Artesunate-Amodiaquine and Their Relation with Multiplicity of Infection in the Democratic Republic of Congo.

Hypolite Muhindo Mavoko, Marion Kalabuanga, Christopher Delgado-Ratto, Vivi Maketa, Rodin Mukele, Blaise Fungula, Raquel Inocêncio da Luz, Anna Rosanas-Urgell, Pascal Lutumba, Jean-Pierre Van Geertruyden

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01374581 (A Randomized Clinical Trial to Measure the Impact of Retreatment With an Artemisinin-based Combination on Malaria Incidence and Its Potential Selection of Resistant Strains), which is not on this map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT01374581 phase3completednot on this map

A Randomized Clinical Trial to Measure the Impact of Retreatment With an Artemisinin-based Combination on Malaria Incidence and Its Potential Selection of Resistant Strains

TypeinterventionalSponsorUniversiteit AntwerpenRan2012 to 2014Enrolled2,117ConditionsMalariaArmsArtemether/Lumefantrine, Artesunate/Amodiaquine, Quinine + Clindamycin
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 26 citations in OpenAlex.

  1. Trial
  2. A retrospective analysis ofAntimicrobial agents and chemotherapy · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Hypolite Muhindo MavokoTropical Medicine Department, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Marion KalabuangaOutpatients Department, Lisungi Health Center, Kinshasa, Democratic Republic of Congo.
Christopher Delgado-RattoGlobal Health Institute, University of Antwerp, Antwerp, Belgium.
Vivi MaketaTropical Medicine Department, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Rodin MukeleTropical Medicine Department, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Blaise FungulaOutpatients Department, Lisungi Health Center, Kinshasa, Democratic Republic of Congo.
Raquel Inocêncio da LuzGlobal Health Institute, University of Antwerp, Antwerp, Belgium.
Anna Rosanas-UrgellInstitute of Tropical Medicine, Antwerp, Belgium.
Pascal LutumbaTropical Medicine Department, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Jean-Pierre Van GeertruydenGlobal Health Institute, University of Antwerp, Antwerp, Belgium.
University of Kinshasa · CDUniversity of Antwerp · BEInstituut voor Tropische Geneeskunde · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the Democratic Republic of Congo, artesunate-amodiaquine (ASAQ) is the first-line medication recommended for uncomplicated malaria treatment. We conducted a study in Kinshasa to describe the clinical features of the disease and assess the efficacy of ASAQ and its impact on the multiplicity of infection in children with uncomplicated malaria.

methodsChildren aged 12 to 59 months with uncomplicated P. falciparum malaria were treated with ASAQ and followed up passively for 42 days. To distinguish new infections from recrudescent parasites, samples were genotyped using a stepwise strategy with three molecular markers (GLURP, MSP2 and MSP1). We then assessed PCR-corrected and -uncorrected day-42 cure rates and multiplicity of infection (MOI).

resultsIn total, 2,796 patients were screened and 865 enrolled in the study. Clinical features were characterized by history of fever (100%), coryza (59.9%) and weakness (59.4%). The crude and PCR-corrected efficacies of ASAQ were 55.3% (95%CI: 51.8-58.8) and 92.8% (95%CI: 91.0-94.6) respectively, as 83.6% (95%CI: 79.1-87.2) of the recurrences were new infections. Compared to monoclonal infections, polyclonal infections were more frequent at enrollment (88.1%) and in recurrences (80.1%; p = 0.005; OR: 1.8, 95%CI: 1.20-2.8). The median MOI at enrollment (MOI = 3.7; IQR: 0.7-6.7) decreased to 3 (IQR: 1-5) in the recurrent samples (p<0.001). Patients infected with a single haplotype on day 0 had no recrudescence; the risk of recrudescence increased by 28% with each additional haplotype (HR: 1.3, 95%CI: 1.24-1.44).

conclusionThe PCR-corrected efficacy of ASAQ at day 42 was 92.8%, but crude efficacy was relatively poor due to high reinfection rates. Treatment outcomes were positively correlated with MOI. Continued monitoring of the efficacy of ACTs-ASAQ, in this case-is paramount.

trial registrationClinicalTrials.gov NCT01374581.

Indexed as

AmodiaquineAntimalarialsArtemisininsChild, PreschoolDemocratic Republic of the CongoDrug CombinationsFemaleHumansInfantMalaria, FalciparumMalePlasmodium falciparumTreatment OutcomeAmodiaquineamodiaquine, artesunate drug combinationAntimalarialsArtemisininsDrug Combinations

Identifiers

PMID27280792
PMCPMC4900589
OpenAlexW2411245132

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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.