| Author | Andrade, Simone Ladeia | |
| Author | Melo, Gladson Naber P. de | |
| Author | Lima, Rita de Cássia de Souza | |
| Author | Salla, Laís C. | |
| Author | Bastos, Melissa S. | |
| Author | Rodrigues, Priscila T. | |
| Author | Luz, Francisco das Chagas O. | |
| Author | Ferreira, Marcelo U. | |
| Access date | 2018-01-02T11:14:43Z | |
| Available date | 2018-01-02T11:14:43Z | |
| Document date | 2016 | |
| Citation | ANDRADE, Simone Ladeia; et al. No Clinical or Molecular Evidence of Plasmodium falciparum Resistance to Artesunate–Mefloquine in Northwestern Brazil. Am. J. Trop. Med. Hyg., v.95, n.1, p.148–154, 2016. | pt_BR |
| ISSN | 0002-9637 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/23838 | |
| Description | Can archive publisher's version/PDF. Restrictions: 12 months embargo | pt_BR |
| Language | eng | pt_BR |
| Publisher | The American Society of Tropical Medicine and Hygiene | pt_BR |
| Rights | open access | |
| Subject in Portuguese | Plasmodium falciparum | pt_BR |
| Subject in Portuguese | Mefloquina | pt_BR |
| Subject in Portuguese | Tratamento | pt_BR |
| Subject in Portuguese | Noroeste do Brasil | pt_BR |
| Title | No Clinical or Molecular Evidence of Plasmodium falciparum Resistance to Artesunate-Mefloquine in Northwestern Brazil | pt_BR |
| Type | Article | |
| DOI | 10.4269/ajtmh.16-0017 | |
| Abstract | We evaluated the clinical efficacy of artesunate-mefloquine (ASMQ) fixed-dose combination to treat uncomplicated malaria in Juruá Valley, the main Plasmodium falciparum transmission hotspot in Brazil. Between November 2010 and February 2013, we enrolled 162 patients aged 4-73 years, with fever or a history of fever, and a single-species P. falciparum infection confirmed by microscopy and polymerase chain reaction (PCR). All 154 patients who completed the 42-day follow-up presented an adequate clinical and parasitologic response. ASMQ was well tolerated and no adverse event caused treatment interruption. Gametocytes were detected in 46.3% patients; 35.2% had gametocytes at enrollment, whereas others developed patent gametocytemia 1-14 days after starting ASMQ. By day 3 of treatment, all subjects had cleared asexual parasitemia, but parasite DNA remained PCR detectable in 37.6% of them. Day-3 PCR positivity was associated with prolonged gametocyte carriage. We found no molecular evidence of resistance to either MQ (pfmdr1 gene amplification) or AS (mutations in selected kelch13 gene domains known to be associated with AS resistance) in the local P. falciparum population. These results strongly support the use of ASMQ as a first-line regimen to treat uncomplicated P. falciparum malaria in northwestern Brazil, but underscore the need for gametocytocidal drugs to reduce the transmission potential of ASMQ-treated patients (ClinicalTrials.gov number NCT01144702). | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Doenças Parasitárias. Rio de Janeiro, RJ. Brasil / Ministério da Saúde. Rede Amazônica de Vigilância da Resistência às Drogas Antimaláricas. Iniciativa Amazônica contra a Malária. Cruzeiro do Sul, AC, Brasil. | pt_BR |
| Affilliation | Ministério da Saúde. Rede Amazônica de Vigilância da Resistência às Drogas Antimaláricas. Iniciativa Amazônica contra a Malária. Cruzeiro do Sul, AC, Brasil. | pt_BR |
| Affilliation | Ministério da Saúde. Rede Amazônica de Vigilância da Resistência às Drogas Antimaláricas. Iniciativa Amazônica contra a Malária. Cruzeiro do Sul, AC, Brasil. | pt_BR |
| Affilliation | Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Universidade de Brasília. Centro de Medicina Tropical. Brasília, DF, Brasil. | pt_BR |
| Affilliation | Ministério da Saúde. Rede Amazônica de Vigilância da Resistência às Drogas Antimaláricas. Iniciativa Amazônica contra a Malária. Cruzeiro do Sul, AC, Brasil / Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil. | pt_BR |
| Subject | Plasmodium falciparum | pt_BR |
| Subject | Northwestern Brazil | pt_BR |
| Subject | Treatment | pt_BR |
| Subject | mefloquine | pt_BR |
