Therapeutic efficacy and effects of artesunate-amodiaquine and artemetherlumefantrine on malaria-associated anaemia in Nigerian children aged two years and under  

作　　者：Akintunde Sowunmi Kazeem Akano Adejumoke I.Ayede Godwin Ntadom Elsie O.Adewoye Bayo Fatunmbi Temitope Aderoyeje 

机构地区：[1]Department of Pharmacology and Therapeutics,University of Ibadan,Ibadan,Nigeria [2]Institute for Medical Research and Training,University of Ibadan,Ibadan,Nigeria [3]Department of Paediatrics,University of Ibadan,Ibadan,Nigeria [4]Malaria Elimination Programme,Federal Ministry of Health,Abuja,Nigeria [5]Department of Physiology,University of Ibadan,Ibadan,Nigeria [6]World Health Organization,Regional Office for the Western Pacific,Phnom Penh,Cambodia [7]Department of Clinical Pharmacology,University College Hospital,Ibadan,Nigeria

出　　处：《Infectious Diseases of Poverty》2016年第1期622-635,共14页贫困所致传染病（英文）

基　　金：supported by a Swiss Pharma Nigeria PLC Grant given to AS,and by World Bank Malaria Booster Project and the Global Fund for Malaria to Federal Ministry of Health,Abuja,Nigeria through Drug Therapeutic Efficacy Testing in Nigeria.

摘　　要：Background:Artemisinin-based combination therapies are recommended as first-line treatments for uncomplicated falciparum malaria,but there is little evaluation of their efficacy and effects on uncomplicated malaria-associated anaemia in children aged 2 years and under.Methods:Parasitological efficacy and effects on malaria-associated anaemia were evaluated in 250 malarious children aged 2 years and under,and efficacy was evaluated in 603 malarious children older than two but younger than 5 years of age following treatment with artesunate-amodiaquine(AA)or artemether-lumefantrine(AL).Kinetics of the disposition of parasitaemia following treatment were evaluated using a non-compartment model.Late-appearing anaemia(LAA)was diagnosed using the following criteria:clearance of parasitaemia,fever and other symptoms occurring within 7 days of starting treatment,adequate clinical and parasitological response on days 28–42,haematocrit(HCT)≥30%at 1 and/or 2 weeks,a fall in HCT to<30%occurring at 3–6 weeks,absence of concomitant illness at 1–6 weeks,and absence of asexual parasitaemia detected using both microscopy and polymerase chain reaction(PCR)at 1–6 weeks.Results:Overall,in children aged 2 years and under,the PCR-corrected parasitological efficacy was 97.2%(95%CI 92.8–101.6),which was similar for both treatments.In children older than 2 years,parasitological efficacy was also similar for both treatments,but parasite prevalence 1 day after treatment began was significantly higher,and fever and parasite clearance times were significantly faster in the AA-treated children compared with the AL-treated children.Declines in parasitaemia were monoexponential with an estimated elimination half-time of 1 h.Elimination half-times were similar for both treatments.In children aged 2 years and under who were anaemic at presentation,the mean anaemia recovery time was 12.1 days(95%CI 10.6–13.6,n=127),which was similar for both treatments.Relatively asymptomatic LAA occurred in 11 children(4.4%)aged 2 years and under,the

关 键 词：Falciparum malaria Malaria-related anaemia Young children Artemisinin-based combination therapies NIGERIA 

分 类 号：R74[医药卫生—神经病学与精神病学]