Imperial College London
Portrait Picture

DrJosephChallenger

Faculty of Medicine, School of Public Health

Research Fellow
 
 
 
//

Contact

 

j.challenger Website

 
 
//

Location

 

409School of Public HealthWhite City Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Mumtaz:2020:10.1101/2020.08.21.20179382,
author = {Mumtaz, R and Okell, LC and Challenger, JD},
doi = {10.1101/2020.08.21.20179382},
title = {How often do symptoms return after unsuccessful drug treatment for malaria? A systematic review and meta-analysis},
url = {http://dx.doi.org/10.1101/2020.08.21.20179382},
year = {2020}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>In clinical trials of therapies for uncomplicated <jats:italic>Plasmodium falciparum</jats:italic>, there are usually some patients who fail treatment even in the absence of drug resistance. Treatment failures are categorised as ‘clinical’ or ‘parasitological’ failures, the latter indicating that recrudescence of the infection has occurred without inducing the return of symptoms. Asymptomatic treatment failure has public health implications for continued malaria transmission and may be important for the spread of drug-resistant malaria. As the number of treatment failures in an individual trial is often low, it is difficult to assess how commonplace asymptomatic treatment failure is, and with what factors it is associated.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A systematic literature review was carried out on clinical trials of artemether-lumefantrine (AL) in patients seeking treatment for symptomatic uncomplicated falciparum malaria, and information on symptoms during treatment failure was recorded. Only treatment failures examined by polymerase chain reaction (PCR) were included, so as to exclude reinfections. Using a multivariable Bayesian regression model, we explored factors potentially explaining the proportion of recrudescent infections which are symptomatic across the trials included in our study.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Across 60 published trials including 9137 malaria patients we found that 40.8% (95% CIs [35.9-45.8%]) of late treatment failures were symptomatic. We found a positive association between transmission intensity and the observed proportion of treatment failures that were asymptomatic. We also found that symptoms were more likely to return in t
AU  - Mumtaz,R
AU  - Okell,LC
AU  - Challenger,JD
DO  - 10.1101/2020.08.21.20179382
PY  - 2020///
TI  - How often do symptoms return after unsuccessful drug treatment for malaria? A systematic review and meta-analysis
UR  - http://dx.doi.org/10.1101/2020.08.21.20179382
ER  -
Download