蒿甲醚-氨苯曲明(Coartemî)治疗埃塞俄比亚西达玛区Wondogenet worreda地区无并发症恶性疟疾的疗效

Besufikad Eb
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引用次数: 2

摘要

前言:本研究旨在评价复方蒿甲醚®治疗埃塞俄比亚Sidama区Wondogenet Woreda地区无并发症恶性疟疾的疗效。自恶性疟原虫传播以来,寄生虫对几乎所有抗疟单药的耐药性是疟疾控制的严重障碍。自2004年以来,蒿甲醚-氨苯曲明(复方蒿甲醚®)疗法一直在埃塞俄比亚作为无并发症恶性疟疾的一线治疗方法使用。方法:本研究按WHO研究方案设计。研究结果分为早期治疗失败(ETF)、晚期临床失败(LCF)、晚期寄生虫学失败(LPF)和充分的临床和寄生虫学反应(ACPR)。结果:初步研究纳入了99例单恶性疟原虫感染的同意患者,这些患者参加了为期28天的体内复方蒿甲醚治疗随访研究。基于此,复方蒿甲醚的总治愈率为98.9% (PCR未校正)。该研究还发现了4.3%的间日疟原虫和2.2%的恶性疟原虫。随访期结束时的间日合并感染。服用复方蒿甲醚后,第1天和第2天发热迅速消退,第1天和第3天寄生虫清除率很高。因此,本研究显示复方蒿甲醚®对Wondogenet worda地区无并发症的恶性疟疾有很高的治疗效果。结论:复方蒿甲醚治疗单纯恶性疟疾疗效显著。在短时间内清热、消除配子体等方面也有较高的疗效。复方蒿甲醚的耐受性非常好,只有轻微的副作用持续存在。本研究检测到的1.1% LPF与间日疟原虫/间日疟原虫的发生有关。在28天随访结束时,恶性疟原虫合并感染需要进行PCR确认。
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Therapeutic Efficacy of Artemether-Lumefantrine (Coartemî) for theTreatment of Uncomplicated Falciparum Malaria in Wondogenet Woreda,Sidama Zone, Ethiopia
Introduction: The study was conducted to evaluate therapeutic efficacy of Coartem® for the treatment of uncomplicated falciparum malaria in Wondogenet Woreda, Sidama Zone, Ethiopia. Since the spread of Plasmodium falciparum, parasite resistance to almost all antimalarial monotherapies is a serious impediment to malaria control. Artemether-lumefantrine (Coartem®) therapy has been in use as the first-line treatment for uncomplicated falciparum malaria since 2004 in Ethiopia. Methods: The study was designed according to WHO study protocol. The study outcomes were classified into Early Treatment Failure (ETF), Late Clinical Failure (LCF), Late Parasitological Failure (LPF) and Adequate Clinical and Parasitological Response (ACPR). Results: Primary study was conducted on ninety-nine P. falciparum mono-infected consenting patients who were enrolled in the 28-day in vivo Coartem® treatment followup study. Based on this, the overall cure rate for Coartem® was 98.9% (PCR uncorrected). The study also demonstrated 4.3% Plasmodium vivax and 2.2% P. falciparum/P. vivax co-infections at the end of followup period. Following Coartem® treatment, fever was cleared rapidly on days 1 and 2 and parasite clearance was high on days 1 and 3. Therefore, the study showed a high therapeutic efficacy of Coartem® for the treatment of uncomplicated falciparum malaria in Wondogenet Woreda. Conclusion: Coartem® had high efficacy for the treatment of uncomplicated falciparum malaria. It also had high efficacy with respect to clearance of fever and elimination of gametocytes within short period of time. The tolerability of Coartem® was very good with persistence of only minor adverse effects. The 1.1% LPF detected by the study and the occurrence of P. vivax/P. falciparum co-infection at the end of 28 follow up days require PCR confirmation.
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