Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border
© 2018 The Author(s). Background: Malaria has declined dramatically along the Thai-Myanmar border in recent years due to malaria control and elimination programmes. However, at the same time, artemisinin resistance has spread, raising concerns about the efficacy of parenteral artesunate for the trea...
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th-mahidol.460542019-08-28T13:27:06Z Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border Aung Pyae Phyo Kyaw Kyaw Win Aung Myint Thu Lei Lei Swe Htike Htike Candy Beau Kanlaya Sriprawat Markus Winterberg Stephane Proux Mallika Imwong Elizabeth A. Ashley Francois Nosten Mahidol University Nuffield Department of Clinical Medicine Mae Tao Clinic Myanmar Oxford Clinical Research Unit Immunology and Microbiology Medicine © 2018 The Author(s). Background: Malaria has declined dramatically along the Thai-Myanmar border in recent years due to malaria control and elimination programmes. However, at the same time, artemisinin resistance has spread, raising concerns about the efficacy of parenteral artesunate for the treatment of severe malaria. Case presentation: In November 2015 and April 2017, two patients were treated for severe malaria with parenteral artesunate. Quinine was added within 24 h due to an initial poor response to treatment. The first patient died within 24 h of starting treatment and the second did not clear his peripheral parasitaemia until 11 days later. Genotyping revealed artemisinin resistance Kelch-13 markers. Conclusions: Reliable efficacy of artesunate for the treatment of severe malaria may no longer be assured in areas where artemisinin resistance has emerged. Empirical addition of parenteral quinine to artesunate for treatment is recommended as a precautionary measure. 2019-08-23T11:23:12Z 2019-08-23T11:23:12Z 2018-01-15 Article Malaria Journal. Vol.17, No.1 (2018) 10.1186/s12936-018-2182-z 14752875 2-s2.0-85040791038 https://repository.li.mahidol.ac.th/handle/123456789/46054 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85040791038&origin=inward |
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Immunology and Microbiology Medicine Aung Pyae Phyo Kyaw Kyaw Win Aung Myint Thu Lei Lei Swe Htike Htike Candy Beau Kanlaya Sriprawat Markus Winterberg Stephane Proux Mallika Imwong Elizabeth A. Ashley Francois Nosten Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border |
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© 2018 The Author(s). Background: Malaria has declined dramatically along the Thai-Myanmar border in recent years due to malaria control and elimination programmes. However, at the same time, artemisinin resistance has spread, raising concerns about the efficacy of parenteral artesunate for the treatment of severe malaria. Case presentation: In November 2015 and April 2017, two patients were treated for severe malaria with parenteral artesunate. Quinine was added within 24 h due to an initial poor response to treatment. The first patient died within 24 h of starting treatment and the second did not clear his peripheral parasitaemia until 11 days later. Genotyping revealed artemisinin resistance Kelch-13 markers. Conclusions: Reliable efficacy of artesunate for the treatment of severe malaria may no longer be assured in areas where artemisinin resistance has emerged. Empirical addition of parenteral quinine to artesunate for treatment is recommended as a precautionary measure. |
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Mahidol University |
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Mahidol University Aung Pyae Phyo Kyaw Kyaw Win Aung Myint Thu Lei Lei Swe Htike Htike Candy Beau Kanlaya Sriprawat Markus Winterberg Stephane Proux Mallika Imwong Elizabeth A. Ashley Francois Nosten |
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Article |
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Aung Pyae Phyo Kyaw Kyaw Win Aung Myint Thu Lei Lei Swe Htike Htike Candy Beau Kanlaya Sriprawat Markus Winterberg Stephane Proux Mallika Imwong Elizabeth A. Ashley Francois Nosten |
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Aung Pyae Phyo |
title |
Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border |
title_short |
Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border |
title_full |
Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border |
title_fullStr |
Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border |
title_full_unstemmed |
Poor response to artesunate treatment in two patients with severe malaria on the Thai-Myanmar border |
title_sort |
poor response to artesunate treatment in two patients with severe malaria on the thai-myanmar border |
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2019 |
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https://repository.li.mahidol.ac.th/handle/123456789/46054 |
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1763493953655537664 |