Evidence map›Paper›PMID 33468147›Full record

ArticleMalaria journal2021

Anti-malarial efficacy and resistance monitoring of artemether-lumefantrine and dihydroartemisinin-piperaquine shows inadequate efficacy in children in Burkina Faso, 2017-2018.

Adama Gansané, Leah F Moriarty, Didier Ménard, Isidore Yerbanga, Esperance Ouedraogo, Paul Sondo, Rene Kinda, Casimir Tarama, Edwige Soulama, Madou Tapsoba and 7 more

Open access · goldAbstract read
In one paragraph

Article in Malaria journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 6 pooled it
18.0field-weighted citation impact, top 1% 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

61 citing papers in PubMed, 6 syntheses or guidelines pooled it, 110 citations in OpenAlex.

  1. Pooled it
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  13. AbioRxiv : the preprint server for biology · 2026
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  14. Article
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  16. Double Mutations inbioRxiv : the preprint server for biology · 2026
    Article
  17. Single-cell transcriptional changes of artemisinin-sensitive K13Frontiers in cellular and infection microbiology · 2026
    Article
  18. Article
  19. Article
  20. Article

1 more citing papers are in PubMed but not listed here.

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

17 authors at 5 institutions in 3 countries.

Adama GansanéCentre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso. agansane@hotmail.com.
Leah F MoriartyDivision of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, US President's Malaria Initiative, Atlanta, GA, USA.
Didier MénardMalaria Genetics and Resistance Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.
Isidore YerbangaIRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso.
Esperance OuedraogoCentre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso.
Paul SondoIRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso.
Rene KindaCentre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso.
Casimir TaramaCentre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso.
Edwige SoulamaCentre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso.
Madou TapsobaCentre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso.
David KangoyeCentre National de Recherche Et de Formation Sur Le Paludisme, Ouagadougou, Burkina Faso.
Cheick Said CompaoreNational Malaria Control Programme, Ouagadougou, Burkina Faso.
Ousmane BadoloJHPIEGO/ Improving Malaria Care, Ouagadougou, Burkina Faso.
Blami DaoJHPIEGO/ Improving Malaria Care, Ouagadougou, Burkina Faso.
Samuel TchwenkoDivision of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, US President's Malaria Initiative, Atlanta, GA, USA.
Halidou TintoIRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso.
Innocent ValeaIRSS / Unité de Recherche Clinique de Nanoro, Nanoro, Burkina Faso.
Centre National de Recherche et de Formation sur le Paludisme · BFInstitut de Recherche en Sciences de la Santé · BFMalariaGEN · BFCenter for Global Health · USInstitut Pasteur · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe World Health Organization recommends regularly assessing the efficacy of artemisinin-based combination therapy (ACT), which is a critical tool in the fight against malaria. This study evaluated the efficacy of two artemisinin-based combinations recommended to treat uncomplicated Plasmodium falciparum malaria in Burkina Faso in three sites: Niangoloko, Nanoro, and Gourcy.

methodsThis was a two-arm randomized control trial of the efficacy of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Children aged 6-59 months old were monitored for 42 days. The primary outcomes of the study were uncorrected and PCR-corrected efficacies to day 28 for AL and 42 for DP. Molecular markers of resistance to artemisinin derivatives and partner drugs were also analysed.

resultsOf 720 children enrolled, 672 reached study endpoints at day 28, 333 in the AL arm and 339 in the DP arm. PCR-corrected 28-day per protocol efficacy in the AL arm was 74% (64-83%) in Nanoro, 76% (66-83%) in Gourcy, and 92% (84-96%) in Niangoloko. The PCR-corrected 42-day per protocol efficacy in the DP arm was 84% (75-89%) in Gourcy, 89% (81-94%) in Nanoro, and 97% (92-99%) in Niangoloko. No Pfk13 mutation previously associated with artemisinin-resistance was observed. No statistically significant association was found between treatment outcome and presence of the 86Y mutation in the Pfmdr1 gene. There was also no association observed between treatment outcome and Pfpm2 or Pfmdr1 copy number variation.

conclusionThe results of this study indicate evidence of inadequate efficacy of AL at day 28 and DP at day 42 in the same two sites. A change of first-line ACT may be warranted in Burkina Faso. Trial Registry Pan African Clinical Trial Registry Identifier: PACTR201708002499311. Date of registration: 8/3/2017 https://pactr.samrc.ac.za/Search.aspx.

Indexed as

Drug ResistanceAntimalarialsArtemether, Lumefantrine Drug CombinationArtemisininsBurkina FasoChild, PreschoolFemaleHumansInfantMalaria, FalciparumMalePiperazinesQuinolinesAntimalarialsArtemether, Lumefantrine Drug CombinationArtemisininsartenimolpiperaquinePiperazinesQuinolinesAntimalarialArtemether-lumefantrineBurkina fasoDihydroartemisinin-piperaquineEfficacyPlasmodium falciparum

Identifiers

PMID33468147
PMCPMC7816451
OpenAlexW3121951570

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.