@article{fdi:010066927,
  title = {{G}ametocyte carriage in uncomplicated {P}lasmodium falciparum malaria following treatment with artemisinin combination therapy: a systematic review and meta-analysis of individual patient data},
  author = {{A}bdulla, {S}. and {A}chan, {J}. and {A}dam, {I}. and {A}lemayehu, {B}. {H}. and {A}llan, {R}. and {A}llen, {E}. {N}. and {A}nvikar, {A}. {R}. and {A}rinaitwe, {E}. and {A}shley, {E}. {A}. and {A}sih, {P}. {B}. {S}. and {A}wab, {G}. {R}. and {B}arnes, {K}. {I}. and {B}assat, {Q}. and {B}audin, {E}. and {B}jorkman, {A}. and {B}ompart, {F}. and {B}onnet, {M}aryline and {B}orrmann, {S}. and {B}ousema, {T}. and {C}arrara, {V}. {I}. and {C}enci, {F}. and {C}hecchi, {F}. and {C}ot, {M}ichel and {D}ahal, {P}. and {D}'{A}lessandro, {U}. and {D}eloron, {P}hilippe and et al.,},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {G}ametocytes are responsible for transmission of malaria from human to mosquito. {A}rtemisinin combination therapy ({ACT}) reduces post-treatment gametocyte carriage, dependent upon host, parasite and pharmacodynamic factors. {T}he gametocytocidal properties of antimalarial drugs are important for malaria elimination efforts. {A}n individual patient clinical data meta-analysis was undertaken to identify the determinants of gametocyte carriage and the comparative effects of four {ACT}s: artemether-lumefantrine ({AL}), artesunate/amodiaquine ({AS}-{AQ}), artesunate/mefloquine ({AS}-{MQ}), and dihydroartemisinin-piperaquine ({DP}). {M}ethods: {F}actors associated with gametocytaemia prior to, and following, {ACT} treatment were identified in multivariable logistic or {C}ox regression analysis with random effects. {A}ll relevant studies were identified through a systematic review of {P}ub{M}ed. {R}isk of bias was evaluated based on study design, methodology, and missing data. {R}esults: {T}he systematic review identified 169 published and 9 unpublished studies, 126 of which were shared with the {W}orld{W}ide {A}ntimalarial {R}esistance {N}etwork ({WWARN}) and 121 trials including 48,840 patients were included in the analysis. {P}revalence of gametocytaemia by microscopy at enrolment was 12.1 % (5887/48,589), and increased with decreasing age, decreasing asexual parasite density and decreasing haemoglobin concentration, and was higher in patients without fever at presentation. {A}fter {ACT} treatment, gametocytaemia appeared in 1.9 % (95 % {CI}, 1.7-2.1) of patients. {T}he appearance of gametocytaemia was lowest after {AS}-{MQ} and {AL} and significantly higher after {DP} (adjusted hazard ratio ({AHR}), 2.03; 95 % {CI}, 1.24-3.12; {P} = 0.005 compared to {AL}) and {AS}-{AQ} fixed dose combination ({FDC}) ({AHR}, 4.01; 95 % {CI}, 2.40-6.72; {P} < 0.001 compared to {AL}). {A}mong individuals who had gametocytaemia before treatment, gametocytaemia clearance was significantly faster with {AS}-{MQ} ({AHR}, 1.26; 95 % {CI}, 1.00-1.60; {P} = 0.054) and slower with {DP} ({AHR}, 0.74; 95 % {CI}, 0.63-0.88; {P} = 0.001) compared to {AL}. {B}oth recrudescent (adjusted odds ratio ({AOR}), 9.05; 95 % {CI}, 3.74-21.90; {P} < 0.001) and new ({AOR}, 3.03; 95 % {CI}, 1.66-5.54; {P} < 0.001) infections with asexual-stage parasites were strongly associated with development of gametocytaemia after day 7. {C}onclusions: {AS}-{MQ} and {AL} are more effective than {DP} and {AS}-{AQ} {FDC} in preventing gametocytaemia shortly after treatment, suggesting that then on-artemisinin partner drug or the timing of artemisinin dosing are important determinants of post-treatment gametocyte dynamics.},
  keywords = {{M}alaria ; {P}lasmodium falciparum ; {D}rug resistance ; {G}ametocyte ; {AFRIQUE} ; {ASIE} ; {AMERIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{BMC} {M}edicine},
  volume = {14},
  numero = {},
  pages = {art. 79 [18 p.]},
  ISSN = {1741-7015},
  year = {2016},
  DOI = {10.1186/s12916-016-0621-7},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066927},
}