title: No evidence of delayed parasite clearance after oral artesunate treatment of uncomplicated falciparum malaria in Mali.
abstract: Plasmodium falciparum resistance to artemisinins by delayed parasite clearance is present in Southeast Asia. Scant data on parasite clearance after artemisinins are available from Africa, where transmission is high, burden is greatest, and artemisinin use is being scaled up. Children 1-10 years of age with uncomplicated malaria were treated with 7 days of artesunate and followed for 28 days. Blood smears were done every 8 hours until negative by light microscopy. Results were compared with a similar study conducted in the same village in 2002-2004. The polymerase chain reaction-corrected cure rate was 100%, identical to 2002-2004. By 24 hours after treatment initiation, 37.0% of participants had cleared parasitemia, compared with 31.9% in 2002-2004 (P = 0.5). The median parasite clearance time was 32 hours. Only one participant still had parasites at 48 hours and no participant presented parasitemia at 72 hours. Artesunate was highly efficacious, with no evidence of delayed parasite clearance. We provide baseline surveillance data for the emergence or dissemination of P. falciparum resistance in sub-Saharan Africa.
authors: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, Pharmacy, and Odonto-stomatology, University of Bamako, Mali. aw70@duke.edu
authors: Amelia W
authors: AW
authors: Maiga
authors: Bakary
authors: B
authors: Fofana
authors: Issaka
authors: I
authors: Sagara
authors: Demba
authors: D
authors: Dembele
authors: Antoine
authors: A
authors: Dara
authors: Oumar Bila
authors: OB
authors: Traore
authors: Sekou
authors: S
authors: Toure
authors: Kassim
authors: K
authors: Sanogo
authors: Souleymane
authors: S
authors: Dama
authors: Bakary
authors: B
authors: Sidibe
authors: Aminatou
authors: A
authors: Kone
authors: Mahamadou A
authors: MA
authors: Thera
authors: Christopher V
authors: CV
authors: Plowe
authors: Ogobara K
authors: OK
authors: Doumbo
authors: Abdoulaye A
authors: AA
authors: Djimde
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D000077332:Artesunate; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D008302:Mali; D018512:Parasitemia
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate