Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis
Background: Since the World Health Organization recommended single low-dose (0.25 mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant Plasmodium falciparum, several single-site studies have been conducted to...
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th-mahidol.746432022-08-04T11:25:34Z Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis Kasia Stepniewska Georgina S. Humphreys Bronner P. Gonçalves Elaine Craig Roly Gosling Philippe J. Guerin Ric N. Price Karen I. Barnes Jaishree Raman Menno R. Smit Umberto D'Alessandro Will J.R. Stone Anders Bjorkman Aaron M. Samuels Maria I. Arroyo-Arroyo Guido J.H. Bastiaens Joelle M. Brown Alassane Dicko Badria B. El-Sayed Salah Eldin G. Elzaki Alice C. Eziefula Simon Kariuki Titus K. Kwambai Amanda E. Maestre Andreas Martensson Dominic Mosha Richard O. Mwaiswelo Billy E. Ngasala Joseph Okebe Michelle E. Roh Patrick Sawa Alfred B. Tiono Ingrid Chen Chris J. Drakeley Teun Bousema Faculty of Tropical Medicine, Mahidol University Brighton and Sussex Medical School Muhimbili University of Health and Allied Sciences University of the Witwatersrand Faculty of Health Sciences University of Bamako Faculty of Medicine, Pharmacy and Odonto-Stomatology Tropical Medicine Research Institute Sudan Ifakara Health Institute Kenya Medical Research Institute Universidad de Antioquia International Centre of Insect Physiology and Ecology Nairobi National Institute for Communicable Diseases London School of Hygiene & Tropical Medicine Green Templeton College Menzies School of Health Research University of California, San Francisco Centers for Disease Control and Prevention Churchill Hospital Liverpool School of Tropical Medicine Rijnstate Hospital Karolinska Institutet Uppsala Universitet Radboud University Medical Center University of Cape Town Infectious Diseases Data Observatory (IDDO) Centre National de Recherche et de Formation sur le Paludisme Dar es Salaam City Council WorldWide Antimalarial Resistance Network Medicine Background: Since the World Health Organization recommended single low-dose (0.25 mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant Plasmodium falciparum, several single-site studies have been conducted to assess efficacy. Methods: An individual patient meta-Analysis to assess gametocytocidal and transmission-blocking efficacy of PQ in combination with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (1) gametocyte carriage in the first 2 weeks post treatment; and (2) the probability of infecting at least 1 mosquito or of a mosquito becoming infected. Results: In 2574 participants from 14 studies, PQ reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytemia on day 0 (odds ratio [OR],0.22; 95% confidence interval [CI],. 17-.28 and OR,0.12; 95% CI,. 08-.16, respectively). Rate of decline in gametocyte carriage was faster when PQ was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (P=.010 for day 7). Addition of 0.25 mg/kg PQ was associated with near complete prevention of transmission to mosquitoes. Conclusions: Transmission blocking is achieved with 0.25 mg/kg PQ. Gametocyte persistence and infectivity are lower when PQ is combined with AL compared to DP. 2022-08-04T04:25:34Z 2022-08-04T04:25:34Z 2022-04-01 Article Journal of Infectious Diseases. Vol.225, No.7 (2022), 1215-1226 10.1093/infdis/jiaa498 15376613 00221899 2-s2.0-85128161481 https://repository.li.mahidol.ac.th/handle/123456789/74643 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85128161481&origin=inward |
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Medicine Kasia Stepniewska Georgina S. Humphreys Bronner P. Gonçalves Elaine Craig Roly Gosling Philippe J. Guerin Ric N. Price Karen I. Barnes Jaishree Raman Menno R. Smit Umberto D'Alessandro Will J.R. Stone Anders Bjorkman Aaron M. Samuels Maria I. Arroyo-Arroyo Guido J.H. Bastiaens Joelle M. Brown Alassane Dicko Badria B. El-Sayed Salah Eldin G. Elzaki Alice C. Eziefula Simon Kariuki Titus K. Kwambai Amanda E. Maestre Andreas Martensson Dominic Mosha Richard O. Mwaiswelo Billy E. Ngasala Joseph Okebe Michelle E. Roh Patrick Sawa Alfred B. Tiono Ingrid Chen Chris J. Drakeley Teun Bousema Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis |
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Background: Since the World Health Organization recommended single low-dose (0.25 mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant Plasmodium falciparum, several single-site studies have been conducted to assess efficacy. Methods: An individual patient meta-Analysis to assess gametocytocidal and transmission-blocking efficacy of PQ in combination with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (1) gametocyte carriage in the first 2 weeks post treatment; and (2) the probability of infecting at least 1 mosquito or of a mosquito becoming infected. Results: In 2574 participants from 14 studies, PQ reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytemia on day 0 (odds ratio [OR],0.22; 95% confidence interval [CI],. 17-.28 and OR,0.12; 95% CI,. 08-.16, respectively). Rate of decline in gametocyte carriage was faster when PQ was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (P=.010 for day 7). Addition of 0.25 mg/kg PQ was associated with near complete prevention of transmission to mosquitoes. Conclusions: Transmission blocking is achieved with 0.25 mg/kg PQ. Gametocyte persistence and infectivity are lower when PQ is combined with AL compared to DP. |
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Faculty of Tropical Medicine, Mahidol University |
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Faculty of Tropical Medicine, Mahidol University Kasia Stepniewska Georgina S. Humphreys Bronner P. Gonçalves Elaine Craig Roly Gosling Philippe J. Guerin Ric N. Price Karen I. Barnes Jaishree Raman Menno R. Smit Umberto D'Alessandro Will J.R. Stone Anders Bjorkman Aaron M. Samuels Maria I. Arroyo-Arroyo Guido J.H. Bastiaens Joelle M. Brown Alassane Dicko Badria B. El-Sayed Salah Eldin G. Elzaki Alice C. Eziefula Simon Kariuki Titus K. Kwambai Amanda E. Maestre Andreas Martensson Dominic Mosha Richard O. Mwaiswelo Billy E. Ngasala Joseph Okebe Michelle E. Roh Patrick Sawa Alfred B. Tiono Ingrid Chen Chris J. Drakeley Teun Bousema |
format |
Article |
author |
Kasia Stepniewska Georgina S. Humphreys Bronner P. Gonçalves Elaine Craig Roly Gosling Philippe J. Guerin Ric N. Price Karen I. Barnes Jaishree Raman Menno R. Smit Umberto D'Alessandro Will J.R. Stone Anders Bjorkman Aaron M. Samuels Maria I. Arroyo-Arroyo Guido J.H. Bastiaens Joelle M. Brown Alassane Dicko Badria B. El-Sayed Salah Eldin G. Elzaki Alice C. Eziefula Simon Kariuki Titus K. Kwambai Amanda E. Maestre Andreas Martensson Dominic Mosha Richard O. Mwaiswelo Billy E. Ngasala Joseph Okebe Michelle E. Roh Patrick Sawa Alfred B. Tiono Ingrid Chen Chris J. Drakeley Teun Bousema |
author_sort |
Kasia Stepniewska |
title |
Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis |
title_short |
Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis |
title_full |
Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis |
title_fullStr |
Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis |
title_full_unstemmed |
Efficacy of Single-Dose Primaquine with Artemisinin Combination Therapy on Plasmodium falciparum Gametocytes and Transmission: An Individual Patient Meta-Analysis |
title_sort |
efficacy of single-dose primaquine with artemisinin combination therapy on plasmodium falciparum gametocytes and transmission: an individual patient meta-analysis |
publishDate |
2022 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/74643 |
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1763492082114101248 |