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West Africa International Centers of Excellence for Malaria Research: Drug Resistance Patterns to Artemether–Lumefantrine in Senegal, Mali, and The Gambia
Baba Dieye
Baba Dieye
Cheikh Anta Diop University, Dakar, Senegal.
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Muna Affara
Muna Affara
Medical Research Council, The Gambia.
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Lassana Sangare
Lassana Sangare
University of Bamako, Mali.
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Fatou Joof
Fatou Joof
Medical Research Council, The Gambia.
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Yaye D. Ndiaye
Yaye D. Ndiaye
Cheikh Anta Diop University, Dakar, Senegal.
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Jules F. Gomis
Jules F. Gomis
Cheikh Anta Diop University, Dakar, Senegal.
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Mouhamadou Ndiaye
Mouhamadou Ndiaye
Cheikh Anta Diop University, Dakar, Senegal.
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Aminata Mbaye
Aminata Mbaye
Cheikh Anta Diop University, Dakar, Senegal.
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Mouhamadou Diakite
Mouhamadou Diakite
University of Bamako, Mali.
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Ngayo Sy
Ngayo Sy
Cheikh Anta Diop University, Dakar, Senegal.
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Babacar Mbengue
Babacar Mbengue
Cheikh Anta Diop University, Dakar, Senegal.
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Awa B. Deme
Awa B. Deme
Cheikh Anta Diop University, Dakar, Senegal.
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Rachel Daniels
Rachel Daniels
Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Ambroise D. Ahouidi
Ambroise D. Ahouidi
Cheikh Anta Diop University, Dakar, Senegal.
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Tandakha Dieye
Tandakha Dieye
Cheikh Anta Diop University, Dakar, Senegal.
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Ahmad Abdullahi
Ahmad Abdullahi
Medical Research Council, The Gambia.
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Seydou Doumbia
Seydou Doumbia
University of Bamako, Mali.
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Jean L. Ndiaye
Jean L. Ndiaye
Cheikh Anta Diop University, Dakar, Senegal.
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Ayouba Diarra
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University of Bamako, Mali.
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Abubakar Ismaela
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Medical Research Council, The Gambia.
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Mamadou Coulibaly
Mamadou Coulibaly
University of Bamako, Mali.
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Clint Welty
Clint Welty
Tulane University, New Orleans, Louisiana.
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Alfred Amambua Ngwa
Alfred Amambua Ngwa
Medical Research Council, The Gambia.
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Jeffrey Shaffer
Jeffrey Shaffer
Tulane University, New Orleans, Louisiana.
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Umberto D'Alessandro
Umberto D'Alessandro
Medical Research Council, The Gambia.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Institute of Tropical Medicine, Antwerp, Belgium.
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London School of Hygiene and Tropical Medicine, London, United Kingdom.
Institute of Tropical Medicine, Antwerp, Belgium.
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Sarah K. Volkman
Sarah K. Volkman
Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Simmons College School of Nursing and Health Sciences, Boston, Massachusetts.
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The Broad Institute of MIT and Harvard, Cambridge, Massachusetts.
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Dyann F. Wirth
Dyann F. Wirth
Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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The Broad Institute of MIT and Harvard, Cambridge, Massachusetts.
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Donald J. Krogstad
Donald J. Krogstad
Tulane University, New Orleans, Louisiana.
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Ousmane Koita
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University of Bamako, Mali.
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Davis Nwakanma
Davis Nwakanma
Medical Research Council, The Gambia.
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Daouda Ndiaye
Daouda Ndiaye
Cheikh Anta Diop University, Dakar, Senegal.
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In 2006, artemether–lumefantrine (AL) became the first-line treatment of uncomplicated malaria in Senegal, Mali, and the Gambia. To monitor its efficacy, between August 2011 and November 2014, children with uncomplicated Plasmodium falciparum malaria were treated with AL and followed up for 42 days. A total of 463 subjects were enrolled in three sites (246 in Senegal, 97 in Mali, and 120 in Gambia). No early treatment failure was observed and malaria infection cleared in all patients by day 3. Polymerase chain reaction (PCR)-adjusted adequate clinical and parasitological response (ACPR) was 100% in Mali, and the Gambia, and 98.8% in Senegal. However, without PCR adjustment, ACPR was 89.4% overall; 91.5% in Mali, 98.8% in Senegal, and 64.3% in the Gambia (the lower value in the Gambia attributed to poor compliance of the full antimalarial course). However, pfmdr1 mutations were prevalent in Senegal and a decrease in parasite sensitivity to artesunate and lumefantrine (as measured by ex vivo drug assay) was observed at all sites. Recrudescent parasites did not show Kelch 13 (K13) mutations and AL remains highly efficacious in these west African sites.
Author Notes
Financial support: The work was supported by the NIH/ICEMR, International Centre of Excellence for Malaria Research, west Africa (U19AI089696).
Authors' addresses: Baba Dieye, Yaye D. Ndiaye, Jules F. Gomis, Mouhamadou Ndiaye, Aminata Mbaye, Ngayo Sy, Babacar Mbengue, Awa B. Deme, Ambroise D. Ahouidi, Tandakha Dieye, Jean L. Ndiaye, and Daouda Ndiaye, Université Cheikh Anta Diop, BP 5005, Dakar, Fann, Sénégal, E-mails: dieyebaba2004@yahoo.fr, ydndiaye@gmail.com, jules.gomis@gmail.com, mouhamadou.ndiaye@ucad.edu.sn, natou5002@yahoo.fr, ngayosy50@hotmail.com, b.mbengue@yahoo.fr, deme.awa@gmail.com, aahouidi@gmail.com, tandakha.dieye@ucad.edu.sn, jeanloab.ndiaye@ucad.edu.sn, and dndiaye@hsph.harvard.edu. Muna Affara, Fatou Joof, Ahmad Abdullahi, Abubakar Ismaela, Alfred Amambua Ngwa, Umberto D'Alessandro, and Davis Nwakanma, Medical Research Council Unit, Atlantic Boulevard, Fajara, Banjul, The Gambia, E-mails: maffara@mrc.gm, fajoof@mrc.gm, aahmad@mrc.gm, iabubakar@mrc.gm, angwa@mrc.gm, udalessandro@mrc.gm, and dnwakanma@mrc.gm. Lassana Sangre, Mouhamadou Diakite, Seydou Doumbia, Ayouba Diarra, Mamadou Coulibaly, and Ousmane Koita, Université de Bamako, BP 1805, Bamako, Mali, E-mails: lansana.sangare@gmail.com, mdiakite@icermali.org, sdoumbi@gmail.com, adiarra@icemrwaf.org, doudou@icermali.org, and okoita@icermali.org. Clint Welty, Jeffrey Shaffer, and Donald J. Krogstad, Tulane University, New Orleans, LA, E-mails: cwelty@icemrwaf.org, jshaffer@tulane.edu, and donkrogstad@gmail.com. Rachel Daniels, Sarah K. Volkman, and Dyann F. Wirth, Harvard T. H. Chan School of Public Health, Boston, MA, E-mails: rdaniels@broadinstitute.org, svolkman@hsph.harvard.edu, and dfwirth@hsph.harvard.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
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1.
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2.
White NJ, 2004. Antimalarial drug resistance. J Clin Invest 113: 1084–1092.
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3.
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4.
WHO, 2008. World Malaria Report 2008. Geneva, Switzerland: World Health Organization.
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