Evidence map›Paper›PMID 40102390›Full record

Trial reportNature communications2025

Decreased dihydroartemisinin-piperaquine protection against recurrent malaria associated with Plasmodium falciparum plasmepsin 3 copy number variation in Africa.

Leyre Pernaute-Lau, Mario Recker, Mamadou Tékété, Tais Nóbrega de Sousa, Aliou Traore, Bakary Fofana, Kassim Sanogo, Ulrika Morris, Juliana Inoue, Pedro E Ferreira and 10 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
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

20 authors.

Leyre Pernaute-LauDepartment of Microbiology and Tumour Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Mario ReckerCentre for Ecology and Conservation, University of Exeter, Penryn Campus, Penryn, UK.ORCID http://orcid.org/0000-0001-9489-1315
Mamadou TékétéMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.
Tais Nóbrega de SousaDepartment of Microbiology and Tumour Cell Biology, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-6874-9427
Aliou TraoreMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.
Bakary FofanaMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.
Kassim SanogoMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.
Ulrika MorrisDepartment of Microbiology and Tumour Cell Biology, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0003-4734-5754
Juliana InoueInstitute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
Pedro E FerreiraLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.ORCID http://orcid.org/0000-0002-2682-7722
Nouhoum DialloMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.ORCID http://orcid.org/0000-0003-0273-588X
Jürgen BurhenneDepartment of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-2190-1698
Issaka SagaraMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.ORCID http://orcid.org/0000-0002-8555-9983
Alassane DickoMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.
Maria I VeigaLife and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.ORCID http://orcid.org/0000-0002-2205-8102
Walter HaefeliDepartment of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.
Anders BjörkmanDepartment of Microbiology and Tumour Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Abdoulaye A DjimdeMalaria Research and Training Center, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali.ORCID http://orcid.org/0000-0003-0062-2283
Steffen Borrmann *Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
José Pedro Gil *Department of Microbiology and Tumour Cell Biology, Karolinska Institutet, Stockholm, Sweden. jose.pedro.gil@ki.se.ORCID http://orcid.org/0000-0002-6107-9379

Funding

Vetenskapsrådet (Swedish Research Council) 2021-05666Vetenskapsrådet (Swedish Research Council) 2021-06048Vetenskapsrådet (Swedish Research Council) 2021-06048, 2021-03105
6 · The paper itself

Abstract

Dihydroartemisinin-piperaquine (DHA-PPQ) is being recommended in Africa for the management of uncomplicated Plasmodium falciparum malaria and for chemoprevention strategies, based on the ability of piperaquine to delay re-infections. Although therapeutic resistance to piperaquine has been linked to increased copy number in plasmepsin-coding parasite genes (pfpm), their effect on the duration of the post-treatment prophylactic period remains unclear. Here, we retrospectively analyzed data from a randomized clinical trial, where patients received either DHA-PPQ or artesunate-amodiaquine for recurrent malaria episodes over two years. We observed an increase in the relative risk of re-infection among patients receiving DHA-PPQ compared to artesunate-amodiaquine after the first malaria season. This was driven by shorter average times to reinfection and coincided with an increased frequency of infections comprising pfpm3 multi-copy parasites. The decline in post-treatment protection of DHA-PPQ upon repeated use in a high transmission setting raises concerns for its wider use for chemopreventive strategies in Africa.

Indexed as

AntimalarialsArtemisininsAspartic Acid EndopeptidasesDNA Copy Number VariationsMalaria, FalciparumPlasmodium falciparumProtozoan ProteinsQuinolinesAdultAfricaAmodiaquineFemaleHumansMalePiperazinesRecurrenceAmodiaquineAntimalarialsArtemisininsartenimolAspartic Acid EndopeptidasespiperaquinePiperazinesplasmepsinProtozoan ProteinsQuinolines

Identifiers

PMID40102390
PMCPMC11920258

What OpenQuestion holds

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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.