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LUMEFANTRINE DISPOSITION AFTER REPETITIVE TREATMENT OF UNCOMPLICATED MALARIA PATIENTS WITH ARTEMETHER-LUMEFANTRINE IN MALI

BackgroundSince 2006 the national malaria control program in Mali recommended artemether-lumefantrine (AL) as the first-line treatment of uncomplicated malaria. The role of lumefantrine in this combination is to eliminate remaining parasites after the action of artemether and to protect the patient...

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Published in:BMJ global health 2017-02, Vol.2 (Suppl 2), p.A24-A24
Main Authors: Tekete, Mamadou, Burhenne, Juergen, Fofana, Bakary, Toure, Sekou, Dama, Souleymane, Dara, Nianwalou, Traore, Oumar, Sidibe, Bouran, Djimde, Abdoulaye, Haefeli, Walter, Borrmann, Steffen
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container_issue Suppl 2
container_start_page A24
container_title BMJ global health
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creator Tekete, Mamadou
Burhenne, Juergen
Fofana, Bakary
Toure, Sekou
Dama, Souleymane
Dara, Nianwalou
Traore, Oumar
Sidibe, Bouran
Djimde, Abdoulaye
Haefeli, Walter
Borrmann, Steffen
description BackgroundSince 2006 the national malaria control program in Mali recommended artemether-lumefantrine (AL) as the first-line treatment of uncomplicated malaria. The role of lumefantrine in this combination is to eliminate remaining parasites after the action of artemether and to protect the patient against a new blood infection. Some studies showed a correlation between lumefantrine's day 7 concentration and the efficacy of AL after treatment of a single episode of malaria. The objective of this work is to validate this observation after repetitive treatment of uncomplicated malaria patients with AL.MethodsDuring a phase IIIb/IV comparative, randomised, multicentre, clinical study of artemisinin-based combination therapies, we collected plasma on Day 7 from patients treated with standard dose of AL in Sotuba, Bougoula Hameau, and Kolle (Mali). The age of the patients enrolled in this study was from 6 months old. The plasma samples were kept at – 80°C until lumefantrine analysis using high performance liquid chromatography was performed.ResultsWe included 1076 subjects, of which 595 were females and a mean age of 12 years old in this analysis.The median concentration was 66% higher (p
doi_str_mv 10.1136/bmjgh-2016-000260.61
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The role of lumefantrine in this combination is to eliminate remaining parasites after the action of artemether and to protect the patient against a new blood infection. Some studies showed a correlation between lumefantrine's day 7 concentration and the efficacy of AL after treatment of a single episode of malaria. The objective of this work is to validate this observation after repetitive treatment of uncomplicated malaria patients with AL.MethodsDuring a phase IIIb/IV comparative, randomised, multicentre, clinical study of artemisinin-based combination therapies, we collected plasma on Day 7 from patients treated with standard dose of AL in Sotuba, Bougoula Hameau, and Kolle (Mali). The age of the patients enrolled in this study was from 6 months old. The plasma samples were kept at – 80°C until lumefantrine analysis using high performance liquid chromatography was performed.ResultsWe included 1076 subjects, of which 595 were females and a mean age of 12 years old in this analysis.The median concentration was 66% higher (p&lt;0.0001) in patients without recurrent parasite on day 28 compared to patients with recurrent parasitaemia: 509.1 ng/ml (inter quartile range: 329.6–723.2; n=919) vs 372.5 (255.7–538.4; n=157). Day 7 concentrations increased with age; the difference between age group was statistically significant: 305.9 (207.3–491.5, n=140), 447 (290.7–622.9, n=399), 544.7 (383.9–738.5, n=254) and 571.1 (378.8–850.9), n=283) in patients under 5 years old, 5–9 years old, 10–14 years old and 15 years old and older, respectively. Girls under 5 years old had a lower lumefantrine concentration at day 7 compared to other age groups of 223.3 ng/ml (159.7–425.6, n=37).ConclusionsWe found a lower concentration of lumefantrine in patients with recurrent parasitaemia at day 28.</description><identifier>ISSN: 2059-7908</identifier><identifier>EISSN: 2059-7908</identifier><identifier>DOI: 10.1136/bmjgh-2016-000260.61</identifier><language>eng</language><publisher>London: BMJ Publishing Group LTD</publisher><subject>Age ; Global health ; Malaria</subject><ispartof>BMJ global health, 2017-02, Vol.2 (Suppl 2), p.A24-A24</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2017 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://gh.bmj.com/content/2/Suppl_2/A24.2.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://gh.bmj.com/content/2/Suppl_2/A24.2.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,27549,27550,27924,27925,77601,77632</link.rule.ids></links><search><creatorcontrib>Tekete, Mamadou</creatorcontrib><creatorcontrib>Burhenne, Juergen</creatorcontrib><creatorcontrib>Fofana, Bakary</creatorcontrib><creatorcontrib>Toure, Sekou</creatorcontrib><creatorcontrib>Dama, Souleymane</creatorcontrib><creatorcontrib>Dara, Nianwalou</creatorcontrib><creatorcontrib>Traore, Oumar</creatorcontrib><creatorcontrib>Sidibe, Bouran</creatorcontrib><creatorcontrib>Djimde, Abdoulaye</creatorcontrib><creatorcontrib>Haefeli, Walter</creatorcontrib><creatorcontrib>Borrmann, Steffen</creatorcontrib><title>LUMEFANTRINE DISPOSITION AFTER REPETITIVE TREATMENT OF UNCOMPLICATED MALARIA PATIENTS WITH ARTEMETHER-LUMEFANTRINE IN MALI</title><title>BMJ global health</title><description>BackgroundSince 2006 the national malaria control program in Mali recommended artemether-lumefantrine (AL) as the first-line treatment of uncomplicated malaria. The role of lumefantrine in this combination is to eliminate remaining parasites after the action of artemether and to protect the patient against a new blood infection. Some studies showed a correlation between lumefantrine's day 7 concentration and the efficacy of AL after treatment of a single episode of malaria. The objective of this work is to validate this observation after repetitive treatment of uncomplicated malaria patients with AL.MethodsDuring a phase IIIb/IV comparative, randomised, multicentre, clinical study of artemisinin-based combination therapies, we collected plasma on Day 7 from patients treated with standard dose of AL in Sotuba, Bougoula Hameau, and Kolle (Mali). The age of the patients enrolled in this study was from 6 months old. The plasma samples were kept at – 80°C until lumefantrine analysis using high performance liquid chromatography was performed.ResultsWe included 1076 subjects, of which 595 were females and a mean age of 12 years old in this analysis.The median concentration was 66% higher (p&lt;0.0001) in patients without recurrent parasite on day 28 compared to patients with recurrent parasitaemia: 509.1 ng/ml (inter quartile range: 329.6–723.2; n=919) vs 372.5 (255.7–538.4; n=157). Day 7 concentrations increased with age; the difference between age group was statistically significant: 305.9 (207.3–491.5, n=140), 447 (290.7–622.9, n=399), 544.7 (383.9–738.5, n=254) and 571.1 (378.8–850.9), n=283) in patients under 5 years old, 5–9 years old, 10–14 years old and 15 years old and older, respectively. Girls under 5 years old had a lower lumefantrine concentration at day 7 compared to other age groups of 223.3 ng/ml (159.7–425.6, n=37).ConclusionsWe found a lower concentration of lumefantrine in patients with recurrent parasitaemia at day 28.</description><subject>Age</subject><subject>Global health</subject><subject>Malaria</subject><issn>2059-7908</issn><issn>2059-7908</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><recordid>eNqNkD9PwzAQxS0EElXpN2CwxJzWdmI7Ga3WoZbyT6kLo-WkCVBRWpJ2gE-PSxhgY7k73b3fO-kBcIvRFGOfzard9unZIwgzDyFEGJoyfAFGBNHI4xEKL3_N12DS91snw9wVxEbgM1mnMhaZLlUm4UKtinyltMozKGItS1jKQmq3eJBQl1LoVGYa5jFcZ_M8LRI1F1ouYCoSUSoBC6GVE6zgo9JLKEotU6mXsvT-fFHZGVA34Kq1r30z-eljsI6lni-9JL93volXYRphr6p4FUQ1sSFFxDaWY9wGfEPthljOLQqjDaI1b8O6xa21FQnbgPg-cxSnDeb-GNwNvodu_35q-qPZ7k_dm3tpCKWYU5_5vlMFg6ru9n3fNa05dC87230YjMw5aPMdtDkHbYagDcMOmw2Yu_6P-ALNTHZ8</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Tekete, Mamadou</creator><creator>Burhenne, Juergen</creator><creator>Fofana, Bakary</creator><creator>Toure, Sekou</creator><creator>Dama, Souleymane</creator><creator>Dara, Nianwalou</creator><creator>Traore, Oumar</creator><creator>Sidibe, Bouran</creator><creator>Djimde, Abdoulaye</creator><creator>Haefeli, Walter</creator><creator>Borrmann, Steffen</creator><general>BMJ Publishing Group LTD</general><scope>9YT</scope><scope>ACMMV</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>201702</creationdate><title>LUMEFANTRINE DISPOSITION AFTER REPETITIVE TREATMENT OF UNCOMPLICATED MALARIA PATIENTS WITH ARTEMETHER-LUMEFANTRINE IN MALI</title><author>Tekete, Mamadou ; 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The role of lumefantrine in this combination is to eliminate remaining parasites after the action of artemether and to protect the patient against a new blood infection. Some studies showed a correlation between lumefantrine's day 7 concentration and the efficacy of AL after treatment of a single episode of malaria. The objective of this work is to validate this observation after repetitive treatment of uncomplicated malaria patients with AL.MethodsDuring a phase IIIb/IV comparative, randomised, multicentre, clinical study of artemisinin-based combination therapies, we collected plasma on Day 7 from patients treated with standard dose of AL in Sotuba, Bougoula Hameau, and Kolle (Mali). The age of the patients enrolled in this study was from 6 months old. The plasma samples were kept at – 80°C until lumefantrine analysis using high performance liquid chromatography was performed.ResultsWe included 1076 subjects, of which 595 were females and a mean age of 12 years old in this analysis.The median concentration was 66% higher (p&lt;0.0001) in patients without recurrent parasite on day 28 compared to patients with recurrent parasitaemia: 509.1 ng/ml (inter quartile range: 329.6–723.2; n=919) vs 372.5 (255.7–538.4; n=157). Day 7 concentrations increased with age; the difference between age group was statistically significant: 305.9 (207.3–491.5, n=140), 447 (290.7–622.9, n=399), 544.7 (383.9–738.5, n=254) and 571.1 (378.8–850.9), n=283) in patients under 5 years old, 5–9 years old, 10–14 years old and 15 years old and older, respectively. Girls under 5 years old had a lower lumefantrine concentration at day 7 compared to other age groups of 223.3 ng/ml (159.7–425.6, n=37).ConclusionsWe found a lower concentration of lumefantrine in patients with recurrent parasitaemia at day 28.</abstract><cop>London</cop><pub>BMJ Publishing Group LTD</pub><doi>10.1136/bmjgh-2016-000260.61</doi><oa>free_for_read</oa></addata></record>
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subjects Age
Global health
Malaria
title LUMEFANTRINE DISPOSITION AFTER REPETITIVE TREATMENT OF UNCOMPLICATED MALARIA PATIENTS WITH ARTEMETHER-LUMEFANTRINE IN MALI
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