Evidence map›Paper›PMID 28153004›Full record

ArticleMalaria journal2017

Efficacy of artemether-lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine for treatment of uncomplicated Plasmodium falciparum malaria in Angola, 2015.

Mateusz M Plucinski, Pedro Rafael Dimbu, Aleixo Panzo Macaia, Carolina Miguel Ferreira, Claudete Samutondo, Joltim Quivinja, Marília Afonso, Richard Kiniffo, Eliane Mbounga, Julia S Kelley and 8 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Malaria journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 6 pooled it
8.9field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 6 syntheses or guidelines pooled it, 103 citations in OpenAlex.

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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

18 authors at 6 institutions in 3 countries.

Mateusz M PlucinskiMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. mplucinski@cdc.gov.
Pedro Rafael DimbuNational Malaria Control Program, Ministry of Health, Luanda, Angola.
Aleixo Panzo MacaiaFaculty of Medicine, Agostinho Neto University, Luanda, Angola.
Carolina Miguel FerreiraNational Malaria Control Program, Ministry of Health, Luanda, Angola.
Claudete SamutondoField Epidemiology and Laboratory Training Programme, Ministry of Health, Luanda, Angola.
Joltim QuivinjaField Epidemiology and Laboratory Training Programme, Ministry of Health, Luanda, Angola.
Marília AfonsoNational Malaria Control Program, Ministry of Health, Luanda, Angola.
Richard KiniffoWorld Health Organization, Luanda, Angola.
Eliane MboungaPresident's Malaria Initiative, USAID, Luanda, Angola.
Julia S KelleyMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Dhruviben S PatelMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Yun HeMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Eldin TalundzicMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Denise O GarrettMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Eric S HalseyMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Venkatachalam UdhayakumarMalaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Pascal RingwaldGlobal Malaria Programme, World Health Organization, Geneva, Switzerland.
Filomeno FortesNational Malaria Control Program, Ministry of Health, Luanda, Angola.
Centers for Disease Control and Prevention · USMinistry of Health · AOAgostinho Neto University · AOClínica Sagrada Esperança · AOUniversidade Lusíada de Angola · AOWorld Health Organization · CH

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundRecent anti-malarial resistance monitoring in Angola has shown efficacy of artemether-lumefantrine (AL) in certain sites approaching the key 90% lower limit of efficacy recommended for artemisinin-based combination therapy. In addition, a controversial case of malaria unresponsive to artemisinins was reported in a patient infected in Lunda Sul Province in 2013.

methodsDuring January-June 2015, investigators monitored the clinical and parasitological response of children with uncomplicated Plasmodium falciparum infection treated with AL, artesunate-amodiaquine (ASAQ), or dihydroartemisinin-piperaquine (DP). The study comprised two treatment arms in each of three provinces: Benguela (AL, ASAQ), Zaire (AL, DP), and Lunda Sul (ASAQ, DP). Samples from treatment failures were analysed for molecular markers of resistance for artemisinin (K13) and lumefantrine (pfmdr1).

resultsA total of 467 children reached a study endpoint. Fifty-four treatment failures were observed: four early treatment failures, 40 re-infections and ten recrudescences. Excluding re-infections, the 28-day microsatellite-corrected efficacy was 96.3% (95% CI 91-100) for AL in Benguela, 99.9% (95-100) for ASAQ in Benguela, 88.1% (81-95) for AL in Zaire, and 100% for ASAQ in Lunda Sul. For DP, the 42-day corrected efficacy was 98.8% (96-100) in Zaire and 100% in Lunda Sul. All treatment failures were wild type for K13, but all AL treatment failures had pfmdr1 haplotypes associated with decreased lumefantrine susceptibility.

conclusionsNo evidence was found to corroborate the specific allegation of artemisinin resistance in Lunda Sul. The efficacy below 90% of AL in Zaire matches findings from 2013 from the same site. Further monitoring, particularly including measurement of lumefantrine blood levels, is recommended.

Indexed as

AmodiaquineAngolaAntimalarialsArtemether, Lumefantrine Drug CombinationArtemisininsChildChild, PreschoolDrug CombinationsEthanolaminesFemaleFluorenesHumansInfantMalaria, FalciparumMalePiperazinesAmodiaquineamodiaquine, artesunate drug combinationAntimalarialsArtemether, Lumefantrine Drug CombinationArtemisininsartenimolDrug CombinationsEthanolaminesFluorenespiperaquinePiperazinesQuinolines

Identifiers

PMID28153004
PMCPMC5290657
OpenAlexW2585849544

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.