Institute of Tropical Medicine Antwerp
Foundation of Public Utility

Four artemisinin-based treatments in African pregnant women with malaria

DSpace/Manakin Repository

Show simple item record Pekyi, D. en_US Ampromfi, A. A. en_US Tinto, H. en_US Traore-Coulibaly, M. en_US Tahita, M. C. en_US Valea, I. en_US Mwapasa, V. en_US Kalilani-Phiri, L. en_US Kalanda, G. en_US Madanitsa, M. en_US Ravinetto, R. en_US Mutabingwa, T. en_US Gbekor, P. en_US Tagbor, H. en_US Antwi, G. en_US Menten, J. en_US De Crop, M. en_US Claeys, Y. en_US Schurmans, C. en_US Van Overmeir, C. en_US Thriemer, K. en_US Van geertruyden, J. P. en_US D'Alessandro, U. en_US Nambozi, M. en_US Mulenga, M. en_US Hachizovu, S. en_US Kabuya, J. B. en_US Mulenga, J. en_US PREGACT Study Group en_US 2017-12-18T12:56:05Z 2017-12-18T12:56:05Z 2016 en_US
dc.identifier.issn 1995-7262 en_US
dc.identifier.other en_US
dc.identifier.other 29 en_US
dc.identifier.other ITG-C11A; ITG-C16A; ITG-C17A; ITG-C18A; ITG-H20B; ITG-H23A; MULTI; DCS; U-CTU; DPH; U-ECMAL; INTER; U-QUAL; JIF; PDF; PMC; Abstract; DSPACE64 en_US
dc.description.abstract BACKGROUND: Information regarding the safety and efficacy of artemisinin combination treatments for malaria in pregnant women is limited, particularly among women who live in sub-Saharan Africa. METHODS: We conducted a multicenter, randomized, open-label trial of treatments for malaria in pregnant women in four African countries. A total of 3428 pregnant women in the second or third trimester who had falciparum malaria (at any parasite density and regardless of symptoms) were treated with artemether-lumefantrine, amodiaquine-artesunate, mefloquine-artesunate, or dihydroartemisinin-piperaquine. The primary end points were the polymerase-chain-reaction (PCR)-adjusted cure rates (i.e., cure of the original infection; new infections during follow-up were not considered to be treatment failures) at day 63 and safety outcomes. RESULTS: The PCR-adjusted cure rates in the per-protocol analysis were 94.8% in the artemether-lumefantrine group, 98.5% in the amodiaquine-artesunate group, 99.2% in the dihydroartemisinin-piperaquine group, and 96.8% in the mefloquine-artesunate group; the PCR-adjusted cure rates in the intention-to-treat analysis were 94.2%, 96.9%, 98.0%, and 95.5%, respectively. There was no significant difference among the amodiaquine-artesunate group, dihydroartemisinin-piperaquine group, and the mefloquine-artesunate group. The cure rate in the artemether-lumefantrine group was significantly lower than that in the other three groups, although the absolute difference was within the 5-percentage-point margin for equivalence. The unadjusted cure rates, used as a measure of the post-treatment prophylactic effect, were significantly lower in the artemether-lumefantrine group (52.5%) than in groups that received amodiaquine-artesunate (82.3%), dihydroartemisinin-piperaquine (86.9%), or mefloquine-artesunate (73.8%). No significant difference in the rate of serious adverse events and in birth outcomes was found among the treatment groups. Drug-related adverse events such as asthenia, poor appetite, dizziness, nausea, and vomiting occurred significantly more frequently in the mefloquine-artesunate group (50.6%) and the amodiaquine-artesunate group (48.5%) than in the dihydroartemisinin-piperaquine group (20.6%) and the artemether-lumefantrine group (11.5%) (P<0.001 for comparison among the four groups). CONCLUSIONS: Artemether-lumefantrine was associated with the fewest adverse effects and with acceptable cure rates but provided the shortest posttreatment prophylaxis, whereas dihydroartemisinin-piperaquine had the best efficacy and an acceptable safety profile. (Funded by the European and Developing Countries Clinical Trials Partnership and others; number, NCT00852423.). en_US
dc.language English en_US
dc.publisher Malawi Medical Journal en_US
dc.relation.uri en_US
dc.subject Malaria en_US
dc.subject Protozoal diseases en_US
dc.subject Pregnancy en_US
dc.subject Women en_US
dc.subject Treatment en_US
dc.subject Artemisinin combination therapies (ACT) en_US
dc.subject ACT en_US
dc.subject PREGACT en_US
dc.subject Africa-General en_US
dc.title Four artemisinin-based treatments in African pregnant women with malaria en_US
dc.type Article en_US
dc.citation.issue 3 en_US
dc.citation.volume 28 en_US
dc.citation.pages 139 en_US
dc.citation.abbreviation Malawi Med J en_US

Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record