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recurrent malaria

Toby Leslie, Sami Nahzat, Walid Sediqi
Around half of the population of Afghanistan resides in areas at risk of malaria transmission. Two species of malaria (Plasmodium vivax and Plasmodium falciparum) account for a high burden of disease-in 2011, there were more than 300,000 confirmed cases. Around 80-95% of malaria is P. vivax Transmission is seasonal and focal, below 2,000 m in altitude, and in irrigated areas which allow breeding of anopheline mosquito vectors. Malaria risk is stratified to improve targeting of interventions. Sixty-three of 400 districts account for ∼85% of cases, and are the target of more intense control efforts...
October 5, 2016: American Journal of Tropical Medicine and Hygiene
Johan Ursing, Lars Rombo, Amabelia Rodrigues, Poul-Erik Kofoed
BACKGROUND: Artemether-lumefantrine (AL) was introduced for treatment of uncomplicated malaria in Guinea-Bissau in 2008. Malaria then resurged and recurrent malaria after treatment with AL and stock-outs of AL were common. This study therefore aimed to assess the efficacy of AL and identify an alternative second line antimalarial. Dihydroartemisinin-piperaquine (DP) was chosen as it has been shown to be safe and efficacious and to reduce the incidence of recurrent malaria. METHODS AND FINDINGS: In a multicentre randomised open-label non-inferiority clinical trial, AL or DP were given over 3 days to children aged 6 months-15 years with uncomplicated P...
2016: PloS One
Feven Wudneh, Ashenafi Assefa, Desalegn Nega, Hussien Mohammed, Hiwot Solomon, Tadesse Kebede, Adugna Woyessa, Yibeltal Assefa, Amha Kebede, Moges Kassa
PURPOSE: Following the increased Plasmodium falciparum resistance to chloroquine and sulfadoxine/pyrimethamine, Ethiopia adopted artemether/lumefantrine (AL) as the first-line treatment for uncomplicated P. falciparum in 2004. According to the recommendation of the World Health Organization, this study was carried out for regular monitoring of the efficacy of AL in treating the uncomplicated P. falciparum malaria in Metema district, Gondar Zone, Northwest Ethiopia. PATIENTS AND METHODS: This is a one-arm prospective 28-day in vivo therapeutic efficacy study among the uncomplicated P...
2016: Therapeutics and Clinical Risk Management
Yury Oliveira Chaves, Allyson Guimarães da Costa, Marcelo Luís Monteiro Pereira, Marcus Vinícius Guimarães de Lacerda, Jordana Grazziela Coelho-Dos-Reis, Olindo Assis Martins-Filho, Andréa Teixeira-Carvalho, Adriana Malheiro, Wuelton Marcelo Monteiro, Patrícia Puccinelli Orlandi, Claudio Romero Farias Marinho, Paulo Afonso Nogueira
BACKGROUND: Plasmodium vivax is the causative agent of human malaria of large geographic distribution, with 35 million cases annually. In Brazil, it is the most prevalent species, being responsible by around 70 % of the malaria cases. METHODS: A cross-sectional study was performed in Manaus (Amazonas, Brazil), including 36 adult patients with primary malaria, 19 with recurrent malaria, and 20 endemic controls. The ex vivo phenotypic features of circulating leukocyte subsets (CD4(+) T-cells, CD8(+) T-cells, NK, NKT, B, B1 and Treg cells) as well as the plasmatic cytokine profile (IL-2, IL-4, IL-6, IL-10, TNF and IFN-γ) were assessed, aiming at establishing patterns of immune response characteristic of primary malaria vs recurrent malaria as compared to endemic controls...
2016: Malaria Journal
Richard Mwaiswelo, Billy Ngasala, Irina Jovel, Berit Aydin-Schmidt, Roland Gosling, Zul Premji, Bruno Mmbando, Anders Björkman, Andreas Mårtensson
BACKGROUND: The World Health Organization (WHO) recently recommended the addition of a single low-dose of the gametocytocidal drug primaquine (PQ) to artemisinin-based combination therapy (ACT) in low transmission settings as a component of pre-elimination or elimination programmes. However, it is unclear whether that influences the ACT cure rate. The study assessed treatment outcome of artemether-lumefantrine (AL) plus a single PQ dose (0.25 mg/kg) versus standard AL regimen for treatment of acute uncomplicated Plasmodium falciparum malaria in Tanzania...
2016: Malaria Journal
Suiane Negreiros, Samela Farias, Giselle Maria Rachid Viana, Sheila Akinyi Okoth, Stella M Chenet, Thayna Maria Holanda de Souza, Paola Marchesini, Venkatachalam Udhayakumar, Marinete Marins Povoa, Ana Carolina Faria E Silva Santelli, Alexandre Macedo de Oliveira
We evaluated the efficacy of chloroquine and primaquine on uncomplicated Plasmodium vivax malaria in Cruzeiro do Sul, Brazil, in 2014. Patients ≥ 5 years of age with either fever or history of fever, and laboratory-confirmed P. vivax monoinfection received chloroquine (total dose = 25 mg/kg) and primaquine (total dose = 3.5 mg/kg), and were followed up for 168 days (24 weeks). We used microsatellite genotyping to differentiate recurrent infections caused by heterologous parasites from those caused by homologous ones...
November 2, 2016: American Journal of Tropical Medicine and Hygiene
Roos Visser, Quirijn de Mast, Imke Munnix, André van der Ven, Ton Dofferhoff
No abstract text is available yet for this article.
August 18, 2016: Travel Medicine and Infectious Disease
Meththananda Herath Herath Mudiyanselage, Nayani Prasangika Weerasinghe, Kithsiri Pathirana, Hasini Dias
BACKGROUND: Cerebral malaria is arguably one of the most common non-traumatic encephalopathies in the developing world. Unless the diagnosis of cerebral malaria is made promptly, the consequence could be disastrous. Even though the diagnosis of cerebral malaria can be made relatively easily in majority of cases atypical presentation can often lead to misdiagnosis or delayed diagnosis. We report a case of an uncommon presentation of Plasmodium falciparum infection in a 17-year-old school girl with altered sensorium, seizures and phobic spasms...
2016: BMC Research Notes
Eskouhie Tchaparian, Nancy C Sambol, Emmanuel Arinaitwe, Shelley A McCormack, Victor Bigira, Humphrey Wanzira, Mary Muhindo, Darren J Creek, Nitin Sukumar, Daniel Blessborn, Jordan W Tappero, Abel Kakuru, Yngve Bergqvist, Francesca T Aweeka, Sunil Parikh
BACKGROUND: The pharmacokinetics and pharmacodynamics of lumefantrine, a component of the most widely used treatment for malaria, artemether-lumefantrine, has not been adequately characterized in young children. METHODS: Capillary whole-blood lumefantrine concentration and treatment outcomes were determined in 105 Ugandan children, ages 6 months to 2 years, who were treated for 249 episodes of Plasmodium falciparum malaria with artemether-lumefantrine. RESULTS: Population pharmacokinetics for lumefantrine used a 2-compartment open model with first-order absorption...
October 15, 2016: Journal of Infectious Diseases
Hypolite Muhindo Mavoko, Marion Kalabuanga, Christopher Delgado-Ratto, Vivi Maketa, Rodin Mukele, Blaise Fungula, Raquel Inocêncio da Luz, Anna Rosanas-Urgell, Pascal Lutumba, Jean-Pierre Van Geertruyden
BACKGROUND: In the Democratic Republic of Congo, artesunate-amodiaquine (ASAQ) is the first-line medication recommended for uncomplicated malaria treatment. We conducted a study in Kinshasa to describe the clinical features of the disease and assess the efficacy of ASAQ and its impact on the multiplicity of infection in children with uncomplicated malaria. METHODS: Children aged 12 to 59 months with uncomplicated P. falciparum malaria were treated with ASAQ and followed up passively for 42 days...
2016: PloS One
Lina Zuluaga-Idárraga, Silvia Blair, Sheila Akinyi Okoth, Venkatachalam Udhayakumar, Paula L Marcet, Ananias A Escalante, Neal Alexander, Carlos Rojas
Plasmodium vivax recurrences help maintain malaria transmission. They are caused by recrudescence, reinfection, or relapse, which are not easily differentiated. A longitudinal observational study took place in Turbo municipality, Colombia. Participants with uncomplicated P. vivax infection received supervised treatment concomitantly with 25 mg/kg chloroquine and 0.25 mg/kg/day primaquine for 14 days. Incidence of recurrence was assessed over 180 days. Samples were genotyped, and origins of recurrences were established...
August 2016: Antimicrobial Agents and Chemotherapy
Ritah F Mutagonda, Appolinary A R Kamuhabwa, Omary M S Minzi, Siriel N Massawe, Betty A Maganda, Eleni Aklillu
BACKGROUND: Day 7 plasma concentrations of lumefantrine (LF) can serve as a marker to predict malaria treatment outcome in different study populations. Two main cut-off points (175 and 280 ng/ml) are used to indicate plasma concentrations of LF, below which treatment failure is anticipated. However, there is limited data on the cumulative risk of recurrent parasitaemia (RP) in relation to day 7 LF plasma concentrations in pregnant women. This study describes the prevalence, severity, factors influencing treatment outcome of malaria in pregnancy and day 7 LF plasma concentration therapeutic cut-off points that predicts treatment outcome in pregnant women...
2016: Malaria Journal
Sheila Vitor-Silva, André Machado Siqueira, Vanderson de Souza Sampaio, Caterina Guinovart, Roberto Carlos Reyes-Lecca, Gisely Cardoso de Melo, Wuelton Marcelo Monteiro, Hernando A Del Portillo, Pedro Alonso, Quique Bassat, Marcus Vinícius Guimarães Lacerda
BACKGROUND: In recent years, considerable success in reducing its incidence has been achieved in Brazil, leading to a relative increase in the proportion of cases caused by Plasmodium vivax, considered a harder-to-eliminate parasite. This study aim is to describe the transmission dynamics and associated risk factors in a rural settlement area in the Western Brazilian Amazon. METHODS: A prospective cohort was established in a rural settlement area for 3 years. Follow-up included continuous passive case detection and monthly active case detection for a period of 6 months...
2016: Malaria Journal
Sunil Parikh, Richard Kajubi, Liusheng Huang, Joshua Ssebuliba, Sylvia Kiconco, Qin Gao, Fangyong Li, Moses Were, Abel Kakuru, Jane Achan, Norah Mwebaza, Francesca T Aweeka
BACKGROUND: The optimal treatment of malaria in human immunodeficiency virus (HIV)-infected children requires consideration of critical drug-drug interactions in coinfected children, as these may significantly impact drug exposure and clinical outcomes. METHODS: We conducted an intensive and sparse pharmacokinetic/pharmacodynamic study in Uganda of the most widely adopted artemisinin-based combination therapy, artemether-lumefantrine. HIV-infected children on 3 different first-line antiretroviral therapy (ART) regimens were compared to HIV-uninfected children not on ART, all of whom required treatment for Plasmodium falciparum malaria...
August 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Benedikt Ley, Mohammad Shafiul Alam, Kamala Thriemer, Mohammad Sharif Hossain, Mohammad Golam Kibria, Sarah Auburn, Eugenie Poirot, Ric N Price, Wasif Ali Khan
BACKGROUND: The Bangladeshi national treatment guidelines for uncomplicated malaria follow WHO recommendations but without G6PD testing prior to primaquine administration. A prospective observational study was conducted to assess the efficacy of the current antimalarial policy. METHODS: Patients with uncomplicated malaria, confirmed by microscopy, attending a health care facility in the Chittagong Hill Tracts, Bangladesh, were treated with artemether-lumefantrine (days 0-2) plus single dose primaquine (0...
2016: PloS One
Thomas J Peto, Sabine E Kloprogge, Rupam Tripura, Chea Nguon, Nou Sanann, Sovann Yok, Chhouen Heng, Cholrawee Promnarate, Jeremy Chalk, Ngak Song, Sue J Lee, Yoel Lubell, Mehul Dhorda, Mallika Imwong, Nicholas J White, Lorenz von Seidlein, Arjen Dondorp
BACKGROUND: Treatment of the sub-clinical reservoir of malaria, which may maintain transmission, could be an important component of elimination strategies. The reliable detection of asymptomatic infections with low levels of parasitaemia requires high-volume quantitative polymerase chain reaction (uPCR), which is impractical to conduct on a large scale. It is unknown to what extent sub-clinical parasitaemias originate from recent or older clinical episodes. This study explored the association between clinical history of malaria and subsequent sub-clinical parasitaemia...
2016: Malaria Journal
Diana-Isabela Costescu Strachinaru, Julien Cambier, Helga Kandet-Yattara, Deborah Konopnicki
Current population displacements favor the re-emerging of diseases, nowadays very rare in Europe. We report two cases of 'imported' relapsing fever in two Somali asylum seekers occurring shortly after their arrival in Belgium. A diagnosis of relapsing fever should be considered in all migrants coming from endemic regions or having traveled in low hygiene and crowded conditions, presenting with recurrent fever, especially if no malaria parasites are found.
April 26, 2016: Acta Clinica Belgica
B Witkowski, N Khim, S Kim, A Domergue, V Duru, D Menard
Cases of treatment failures following administration of artemisinin-based combination therapies (ACT) remain rare in malaria endemic areas. In Cambodia, however, failures of these treatments are now commonly observed. Usually, these post-treatment recurrences occur only once and a second course of the same treatment is sufficient to cure patients.We describe here an atypical case of a Plasmodium falciparum-infected patient manifesting several malaria recrudescence episodes following dihydroartemisinin-piperaquine (Eurartesim®) treatment...
May 2016: Bulletin de la Société de Pathologie Exotique
Joachim Richter, Gabriele Franken, Martha C Holtfreter, Susanne Walter, Alfons Labisch, Heinz Mehlhorn
Malaria recurrences after an initially successful therapy and malarial fever occurring a long time after infection are well-known problems in malariology. Currently, two distinct types of malaria recurrences are defined: recrudescence and relapse. A recrudescence is thought to originate from circulating Plasmodium blood stages which do not cause fever before a certain level of a microscopically detectable parasitemia is reached. Contrary, a relapse is thought to originate from quiescent intracellular hepatic parasite stages called hypnozoites...
June 2016: Parasitology Research
Dinberu Seyoum, Yehenew Getachew Kifle, Virginie Rondeau, Delenasaw Yewhalaw, Luc Duchateau, Angel Rosas-Aguirre, Niko Speybroeck
BACKGROUND: The identification of epidemiological pattern of infection with Plasmodium falciparum and Plasmodium vivax in malaria-endemic area, where multiple episodes are common, is important for intervention programmes. METHODS: A longitudinal cohort study based on weekly house-to-house visits was conducted between July 2008 and June 2010 in 2040 children less than 10 years of age, living nearby the Gilgel-Gibe hydroelectric power dam reservoir in order to determine factors associated with increased P...
2016: Malaria Journal
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