Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa.
Humans
Artesunate
/ therapeutic use
Antimalarials
/ therapeutic use
Neutrophils
Malaria, Falciparum
/ drug therapy
Parasitemia
/ drug therapy
Prospective Studies
Artemether, Lumefantrine Drug Combination
/ therapeutic use
Amodiaquine
/ therapeutic use
Artemisinins
/ therapeutic use
Malaria
/ drug therapy
Drug Combinations
Neutropenia
/ chemically induced
Africa
Plasmodium falciparum
Ethanolamines
/ therapeutic use
West Africa
artemisinin-based combination therapy
malaria
neutrophils
Journal
Journal of infection in developing countries
ISSN: 1972-2680
Titre abrégé: J Infect Dev Ctries
Pays: Italy
ID NLM: 101305410
Informations de publication
Date de publication:
30 09 2023
30 09 2023
Historique:
received:
10
07
2022
accepted:
04
03
2023
medline:
1
11
2023
pubmed:
12
10
2023
entrez:
12
10
2023
Statut:
epublish
Résumé
Polymorphonuclear neutrophils (PMN) are involved in pathogen clearance by phagocytosis. However, the role of PMNs in the efficacy of artemisinin-based combination therapy (ACT) is poorly understood. In a prospective longitudinal in vivo study, neutrophil rates were compared with malaria carriage after treatment with different ACTs: Artemether - lumefantrine (AL), Artesunate - amodiaquine (ASAQ), Dihydroartemisinin - piperaquine (DP) or Pyronaridine artesunate (PA). The study cases were classified as having neutropenia, normal neutrophil levels or neutrophilia depending on the level of neutrophils in the blood. This study included 3148 patients and was analyzed using R. On day 7, only four patients in the neutropenia group and treated with AL had a malaria positive blood smear based on microscopy. On day 28, the rate of recurrent parasitemia in the AL arm was significantly higher in neutropenia patients (50.9%) than in patients with normal rates of neutrophils (43.1%) or in those with neutrophilia (6.0%) (p < 0.001). In ASAQ arm, the rate of recurrent Plasmodium falciparum parasitemia was 58.8% in the neutropenia group versus 29.4% in patients with normal rates of neutrophils and 11.8% in patients with neutrophilia (p < 0.001). No patient treated with DP with normal neutrophil counts or neutrophilia was carrying malaria parasites on day 28. Among the 15 patients with parasitemia on day 28 in the PA arm, 11 (73.33%) had neutropenia while 4 (26.67%) had a normal neutrophil count (p < 0.001). Patients with neutropenia had higher rates of recurrent P. falciparum parasitemia after ACT.
Substances chimiques
Artesunate
60W3249T9M
Antimalarials
0
Artemether, Lumefantrine Drug Combination
0
Amodiaquine
220236ED28
artenimol
6A9O50735X
Artemisinins
0
Drug Combinations
0
Ethanolamines
0
Banques de données
PACTR
['PACTR201105000286876']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1337-1345Informations de copyright
Copyright (c) 2023 Moussa Djimde, Kassoum Kayentao, Japhet Kabalu Tshiongo, Bakary Fofana, Charles Arama, Sodiomon B Sirima, Jean Bosco Ouedraogo, Abdoul Habib Beavogui, Issaka Sagara, Alassane Dicko, Petra F Mens, Henk DFH Schallig, Abdoulaye Djimde.
Déclaration de conflit d'intérêts
No Conflict of Interest is declared