ArticleAntimicrobial agents and chemotherapy2019
Improving Methods for Analyzing Antimalarial Drug Efficacy Trials: Molecular Correction Based on Length-Polymorphic Markers
Article in Antimicrobial agents and chemotherapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Classification of outcomes in antimalarial therapeutic efficacy studies with Aster.Antimicrobial agents and chemotherapy · 2026Article
- Target product profiles of laboratory and data analytical frameworks for genotyping to monitor antimalarial efficacy.PLOS global public health · 2026Article
- Probabilistic classification of late treatment failure in uncomplicated falciparum malaria.Nature communications · 2025Article
- Classification of outcomes in antimalarial therapeutic efficacy studies with Aster.bioRxiv : the preprint server for biology · 2025Article
- Artemether-Lumefantrine Treatment Selects Plasmodium falciparum Multidrug Resistance 1 (pfmdr1) Increased Copy Number Among African Malaria Infections.The Journal of infectious diseases · 2025Article
- Assessment of different genotyping markers and algorithms for distinguishing Plasmodium falciparum recrudescence from reinfection in Uganda.Scientific reports · 2025Article
- Bridging the Gap from Molecular Surveillance to Programmatic Decisions for Malaria Control and Elimination.The American journal of tropical medicine and hygiene · 2025Review
- Genotyping and CharacterizingTropical medicine and infectious disease · 2024Review
- Therapeutic response to four artemisinin-based combination therapies in Angola, 2021.Antimicrobial agents and chemotherapy · 2024Article
- Beninese Plant Extracts with Antiplasmodial Activity Select New Allele VariantsJournal of parasitology research · 2024Article
- Prevalence of malaria among febrile patients and assessment of efficacy of artemether-lumefantrine and artesunate-amodiaquine for uncomplicated malaria in Dolisie, Republic of the Congo.Malaria journal · 2022Article
- Artesunate-amodiaquine and artemether-lumefantrine for the treatment of uncomplicated falciparum malaria in Liberia: in vivo efficacy and frequency of molecular markers.Malaria journal · 2022Article
- Plasmodium falciparum histidine rich protein 2 (pfhrp2): an additional genetic marker suitable for anti-malarial drug efficacy trials.Malaria journal · 2022Article
- Genetic surveillance for monitoring the impact of drug use on Plasmodium falciparum populations.International journal for parasitology. Drugs and drug resistance · 2021Review
- Should Deep-Sequenced Amplicons Become the New Gold Standard for Analyzing Malaria Drug Clinical Trials?Antimicrobial agents and chemotherapy · 2021Article
- Therapeutic efficacy of artesunate-amodiaquine and artemether-lumefantrine and polymorphism in Plasmodium falciparum kelch13-propeller gene in Equatorial Guinea.Malaria journal · 2021Article
- Genetic diversity and complexity of Plasmodium falciparum infections in the microenvironment among siblings of the same household in North-Central Nigeria.Malaria journal · 2020Article
- A Computer Modelling Approach To Evaluate the Accuracy of Microsatellite Markers for Classification of Recurrent Infections during Routine Monitoring of Antimalarial Drug Efficacy.Antimicrobial agents and chemotherapy · 2020Article
- Amplicon deep sequencing improves Plasmodium falciparum genotyping in clinical trials of antimalarial drugs.Scientific reports · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Drug efficacy trials monitor the continued efficacy of front-line drugs against falciparum malaria. Overestimating efficacy results in a country retaining a failing drug as first-line treatment with associated increases in morbidity and mortality, while underestimating drug effectiveness leads to removal of an effective treatment with substantial practical and economic implications. Trials are challenging: they require long durations of follow-up to detect drug failures, and patients are frequently reinfected during that period. Molecular correction based on parasite genotypes distinguishes reinfections from drug failures to ensure the accuracy of failure rate estimates. Several molecular correction "algorithms" have been proposed, but which is most accurate and/or robust remains unknown. We used pharmacological modeling to simulate parasite dynamics and genetic signals that occur in patients enrolled in malaria drug clinical trials. We compared estimates of treatment failure obtained from a selection of proposed molecular correction algorithms against the known "true" failure rate in the model. Our findings are as follows. (i) Molecular correction is essential to avoid substantial overestimates of drug failure rates. (ii) The current WHO-recommended algorithm consistently underestimates the true failure rate. (iii) Newly proposed algorithms produce more accurate failure rate estimates; the most accurate algorithm depends on the choice of drug, trial follow-up length, and transmission intensity. (iv) Long durations of patient follow-up may be counterproductive; large numbers of new infections accumulate and may be misclassified, overestimating drug failure rate. (v) Our model was highly consistent with existing
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