The Experts below are selected from a list of 69 Experts worldwide ranked by ideXlab platform
Jasper W Ogwal-okeng - One of the best experts on this subject based on the ideXlab platform.
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria Journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Background Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem^® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Methods Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. Results The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. Conclusion The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.
Grant Dorsey - One of the best experts on this subject based on the ideXlab platform.
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Combination Therapy for Uncomplicated Falciparum Malaria in Ugandan Children
2017Co-Authors: Grant Dorsey, Sarah G. Staedke, Tamara D. Clark, Bridget Nzarubara, Catherine Maiteki-sebuguzi, Moses R. Kamya, Philip J. RosenthalAbstract:sidered, the risks of failure were 14.1% (95% CI, 10.3%-19.2%), 4.6% (95% CI, 2.5%8.3%), and 1.0% (95% CI, 0.3%-4.0%) for the same order of study drugs, respectively (P.008 for all pairwise comparisons, except Amodiaquine Plus Artesunate vs artemether-lumefantrine, P=.05). There were no deaths or cases of severe malaria. Significant reductions in anemia (9.3% [95% CI, 7.0%-12.0%] at enrollment vs 0.6% [95% CI, 0.1%-2.2%] during the last 2 months of follow-up; P.001) and asymptomatic parasitemia (18.6% [95% CI, 15.5%-22.1%] at enrollment vs 2.3% [95% CI, 1.5%-3.5%] during the last 2 months of follow-up; P.001) were observed according to routine testing. Conclusions Artemether-lumefantrine was the most efficacious treatment for uncomplicated malaria in the study population. With all study regimens, the provision of prompt and reasonably effective facility-based treatment was associated with good outcomes in long-term health measures. Trial Registration isrctn.org Identifier: ISRCTN37517549
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Impact of Transmission Intensity on the Accuracy of Genotyping To Distinguish Recrudescence from New Infection in Antimalarial Clinical Trials
Antimicrobial agents and chemotherapy, 2007Co-Authors: Bryan Greenhouse, Philip J. Rosenthal, Christian Dokomajilar, Alan Hubbard, Grant DorseyAbstract:Antimalarial clinical trials use genotyping techniques to distinguish new infection from recrudescence. In areas of high transmission, the accuracy of genotyping may be compromised due to the high number of infecting parasite strains. We compared the accuracies of genotyping methods, using up to six genotyping markers, to assign outcomes for two large antimalarial trials performed in areas of Africa with different transmission intensities. We then estimated the probability of genotyping misclassification and its effect on trial results. At a moderate-transmission site, three genotyping markers were sufficient to generate accurate estimates of treatment failure. At a high-transmission site, even with six markers, estimates of treatment failure were 20% for Amodiaquine Plus Artesunate and 17% for artemether-lumefantrine, regimens expected to be highly efficacious. Of the observed treatment failures for these two regimens, we estimated that at least 45% and 35%, respectively, were new infections misclassified as recrudescences. Increasing the number of genotyping markers improved the ability to distinguish new infection from recrudescence at a moderate-transmission site, but using six markers appeared inadequate at a high-transmission site. Genotyping-adjusted estimates of treatment failure from high-transmission sites may represent substantial overestimates of the true risk of treatment failure.
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Combination therapy for uncomplicated falciparum malaria in Ugandan children: a randomized trial.
JAMA, 2007Co-Authors: Grant Dorsey, Sarah G. Staedke, Tamara D. Clark, Denise Njama-meya, Bridget Nzarubara, Catherine Maiteki-sebuguzi, Christian Dokomajilar, Moses R. Kamya, Philip J. RosenthalAbstract:ContextCombination therapy is now widely advocated as first-line treatment for uncomplicated malaria in Africa. However, it is not clear which treatment regimens are optimal or how to best assess comparative efficacies in highly endemic areas.ObjectiveTo compare the efficacy and safety of 3 leading combination therapies for the treatment of uncomplicated malaria.Design, Setting, and ParticipantsSingle-blind randomized clinical trial, conducted between November 2004 and June 2006, of treatment for all episodes of uncomplicated malaria in children in an urban community in Kampala, Uganda. A total of 601 healthy children (aged 1-10 years) were randomly selected and were followed up for 13 to 19 months, receiving all medical care at the study clinic.InterventionsStudy participants were randomized to receive 1 of 3 combination therapies (Amodiaquine Plus sulfadoxine-pyrimethamine, Amodiaquine Plus Artesunate, or artemether-lumefantrine) when diagnosed with their first episode of uncomplicated malaria. The same assigned treatment was given for all subsequent episodes.Main Outcome Measure28-Day risk of parasitological failure (unadjusted and adjusted by genotyping to distinguish recrudescence from new infection) for each episode of uncomplicated malaria treated with study drugs.ResultsOf enrolled children, 329 of 601 were diagnosed with at least 1 episode of uncomplicated malaria, and 687 episodes of Plasmodium falciparum malaria were treated with study drugs. The 28-day risk of treatment failure (unadjusted by genotyping) for individual episodes of malaria were 26.1% (95% CI, 21.1%-32.1%) for Amodiaquine Plus sulfadoxine-pyrimethamine, 17.4% (95% CI, 13.1%-23.1%) for Amodiaquine Plus Artesunate, and 6.7% (95% CI, 3.9%-11.2%) for artemether-lumefantrine (P
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DISTINGUISHING RECRUDESCENCES FROM NEW INFECTIONS IN ANTIMALARIAL CLINICAL TRIALS: MAJOR IMPACT OF INTERPRETATION OF GENOTYPING RESULTS ON ESTIMATES OF DRUG EFFICACY
The American journal of tropical medicine and hygiene, 2005Co-Authors: Madeline Slater, Moses R. Kamya, Philip J. Rosenthal, Moses Kiggundu, Chris Dokomajilar, Nathan Bakyaita, Ambrose Talisuna, Grant DorseyAbstract:The use of molecular genotyping to distinguish recrudescence from new infections has become common in antimalarial clinical trials. However, methods used to interpret genotyping results have not been standardized. We analyzed data from 3,000 patients enrolled in clinical trials at seven sites in Uganda. Late treatment failure requiring genotyping occurred in 51% of the patients. Among samples successfully genotyped, 21% were definitive new infections (no recrudescent strains present on day of failure), 35% were definitive recrudescences (only recrudescent strains present), and 44% were mixed (new and recrudescent strains present). The probability of having a mixed genotyping result increased as transmission intensity increased. At the highest transmission site, the estimated risk of treatment failure increased from 34% to 84% for chloroquine Plus sulfadoxine-pyrimethamine, from 18% to 45% for Amodiaquine Plus sulfadoxine-pyrimethamine, and from 12% to 57% for Amodiaquine Plus Artesunate, depending on whether mixed genotyping results were classified as new infections or recrudescences, respectively. The method used to classify treatment outcomes can have a major impact on estimates of drug efficacy, especially in areas of high transmission intensity.
Muhammad Ntale - One of the best experts on this subject based on the ideXlab platform.
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria Journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Background Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem^® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Methods Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. Results The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. Conclusion The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.
Margarita Mahindi - One of the best experts on this subject based on the ideXlab platform.
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ral ssBioMed CentMalaria Journal
2016Co-Authors: Open Accemethodology, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W OgwalAbstract:Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combinatio
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria Journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Background Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem^® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Methods Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. Results The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. Conclusion The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.
Lars L Gustafsson - One of the best experts on this subject based on the ideXlab platform.
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ral ssBioMed CentMalaria Journal
2016Co-Authors: Open Accemethodology, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W OgwalAbstract:Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combinatio
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria Journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Background Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem^® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Methods Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. Results The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. Conclusion The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.
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Field-adapted sampling of whole blood to determine the levels of Amodiaquine and its metabolite in children with uncomplicated malaria treated with Amodiaquine Plus Artesunate combination
Malaria journal, 2009Co-Authors: Muhammad Ntale, Celestino Obua, Jackson Mukonzo, Margarita Mahindi, Lars L Gustafsson, Olof Beck, Jasper W Ogwal-okengAbstract:Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, Amodiaquine Plus Artesunate (AQ+AS), is the alternative first-line regimen to Coartem® (artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring Amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine Amodiaquine and its metabolite concentrations in whole blood dried on filter paper. Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of Amodiaquine and its metabolite in whole blood. The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed. The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of Amodiaquine up to 28 days suggested that the method is sensitive enough to monitor Amodiaquine utilization in patients. Amodiaquine Plus Artesunate seems effective for treatment of falciparum malaria.