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- W4387457907 abstract "The study aims to monitor dihydroartemisinin-piperaquine (DHA-PPQ) efficacy in Plasmodium falciparum and detect molecular markers associated with its resistance.The world health organization standard protocol of the therapeutic efficacy study (TES) were performed in 2014-2018 and the integrated drug efficacy surveillance (iDES) in 2019-July 2023. Molecular markers were detected by polymerase chain reaction. The association between gene mutations and delayed parasite clearance were analyzed by the multivariate logistic regression analysis.A total of 226 P. falciparum patients were enrolled in the TES in 2014-2018, and 26 P. falciparum patients imported from Africa were recruited in the iDES in 2019-July 2023. The PCR-adjusted clinical and parasitological cure rate was 93.7% (95%CI: 92.6-99.5%) in the TES and 96.2% (95%CI: 80.4-99.9%) in the iDEs. Twelve mutants and an overall 55.0% prevalence of pfK13 mutations were detected. Of them, G533S, C447R, C447S, N458Y, C469Y and A676D were first detected out along the China-Myanmar border. Referred to the wild strain, adjusted odds ratios of treatment failure for G533S, N458Y and P574L by 42 days were 7.54(95% confidence interval [CI]: 1.605- 45.86), 13.68 (95%CI: 1.95- 130.72) and 89.00 (95%CI: 1.98- 2482.1), respectively.The efficacy of DHA-PPQ in 2014-2018 has declined compared to Year 2003-2013, but it is still effective for treatment of P. falciparum malaria. Results of the iDES indicate a risk of artemisinin resistance in Africa. The G533S, N458Y and P574L are associated with delayed parasite clearance and treatment failure." @default.
- W4387457907 created "2023-10-10" @default.
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- W4387457907 date "2023-10-01" @default.
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- W4387457907 title "Dihydroartemisinin-piperaquine efficacy in Plasmodium falciparum treatment and prevalence of drug-resistant molecular markers along China-Myanmar border in 2014-2023" @default.
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- W4387457907 doi "https://doi.org/10.1016/j.jgar.2023.10.001" @default.
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