Complexity of Plasmodium falciparum infections and antimalarial drug efficacy at 7 sites in Uganda.
Malaria infections in Africa frequently include multiple parasite strains. We examined the relationship between the number of infecting Plasmodium falciparum strains and the responses to 3 different combination therapies in 3072 patients with uncomplicated malaria at 7 sites in Uganda. Patients infected with > or =3 strains had almost 3 times the odds of treatment failure (odds ratio, 2.93 [95% confidence interval, 2.51-3.43]; P<.001), compared with those infected with 1 or 2 strains. Our data suggest that efforts to reduce the complexity of infection in highly endemic areas through the use of intermittent presumptive therapy, improved case management, and reduction in transmission intensity may improve the efficacy of antimalarial therapies.
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA.
Sulggi A
SA
Lee
Adoke
A
Yeka
Samuel L
SL
Nsobya
Christian
C
Dokomajilar
Philip J
PJ
Rosenthal
Ambrose
A
Talisuna
Grant
G
Dorsey
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage* / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008875:Middle Aged; D016017:Odds Ratio; D010963:Plasmodium falciparum / Q000145:classification / Q000187:drug effects* / Q000472:pathogenicity; D016896:Treatment Outcome; D014454:Uganda
D000962:Antimalarials