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academies
Journal of Microbiology: Current Research | Volume 2
November 01-02, 2018 | London, UK
7
th
European
Clinical Microbiology Congress
4
th
International Conference on
Ophthalmology and Eye Disorder
Joint Event
&
Efficacy and safety of artesunate-amodiaquine for the treatment of uncomplicated
Plasmodium
falciparum
malaria in Kigobe health center, in Bujumbura Nord district in Burundi
Ndayikunda Claudette
University Teaching Hospital of Kamenge, Burundi
Aim:
To assess the efficacy and safety of artesunate
-amodiaquine for the treatment of uncomplicated
P. falciparum
infections in Kigobe health center, in Bujumbura Nord district.
Background:
The first and second-line treatment for
P.falciparum
in Burundi are respectively artesunate-amodiaquine and
quinine+clindamycin. The latest study conduct in 2006, ACPRwas
94.8% for artesunate-amodiaquine. This study is to evaluate the
efficacy and safety of artesunate-amodiaquine after 10 years of
its use.
Method:
A therapeutic efficacy study was conducted to
evaluate the efficacy and safety of artesunate-amodiaquine
among patients with uncomplicated falciparum malaria in
Kigobe health center, in Bujumbura Nord district. Clinical and
parasitologicalparameterswereassessedovera28dayfollow-up
period. PCR analysis usingmsp1, mps2 and glurpwas conducted
to distinguish recrudescence from re-infection. Mutations
associated with antimalarial drug resistance in K13 gene
(artemisinin resistance), in dhfr/dhps gene (pyrimethamine/
sulfadoxine resistance), copy number variation in Pfplasmepsin
2 (Pfpm2) gene and Pfmdr1 (piperaquine and mefloquine
resistance)were investigatedusingPCRanalysisandsequencing.
Result:
A total of 58 patients were enrolled between November
2015 and June 2016. Mean age (SD; range) was 6.3 years (1.8;
2.3-9) andmeanweight 19.1 kg (5.4; 10-34). Mean temperature
at admission was 38.8°C (1.1; 36.1-40.3) and parasitaemia
geometricmean (range) at day 0was 33 947/ul (2 930-199 800).
Among the 58 patients, 5 were lost to follow-up or withdrawn.
Day 3 positivity rate was 0%. ACPR PCR corrected using per
protocol analysis was 92.3% (81.5-97.9), LPF 1.9% (0.0-10.3)
and LCF 5.8% (1.2-15.9%). No ETF were reported. ACPR PCR
corrected using Kaplan Meir analysis was 92.5% (81.3-97.19).
Artesunate-amodiaquine was well tolerated. There were no
serious adverse reported. Among the 58 isolates analyzedat
day 0, all isolates were wild type for K13. All parasites were
carrying a single copy of Pfplasmepsin 2 gene, but 10.3% of
the parasites were carrying multiple copy of pfmdr1. The
prevalence of quintuple mutants (dhfrN51I+C59R+S108N and
dhpsK540E+A581G) was 34.5%.
Conclusion:
Artesunate-amodiaquine remains efficacious and
waswell tolerated. There isnoevidenceof artemsininresisitance
and by level of sulfadoxine-pyrimethamine which need to
be taken into account for the IPTp policy implementation.
Speaker Biography
Ndayikunda Claudette is a laboratory specialist and a Burundian renowned researcher,
professor and member of the ASLM team, serving as a member of the East African Public
Health Laboratory Network Project operational research. At the university level, she is
the head of the Laboratory at CHU Kamenge Hospital in Bujumbura, which is a University
Teaching Hospital of Burundi. The Laboratory is Burundi’s reference laboratory and here
she performs research on HIV/AIDS, Malaria diseases and microbiology as well as medical
research. She has published more than 50 papers in reputed journals and has been serving
as an editorial board member of 3 journals. She is also engaged in surveillance, education
and capacity building in East African community as a deputy chairperson technical working
group training and building capacity in Burundi.
e:
ndaclau@yahoo.frNdayikunda Claudette, Clinical Microbiology and Eye 2018, Volume 2
DOI: 10.4066/2591-8036-C1-003