Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: A literature review and meta-analysis of individual patient data

by The Worldwide Antimalarial Resistance Network (WWARN) Artemisinin based Combination Therapy (ACT) Africa Baseline Study Group – includes Kiechel JR as co-author. BioMed Central Medicine, 2015, 13:212 DOI 10.1186/s12916-015-0445-x

Summary: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. The three ACTs assessed in this analysis – artemether-lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine – continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

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