Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa

Introduction: Polymorphonuclear neutrophils (PMN) are involved in pathogen clearance by phagocytosis. However, the role of PMNs in the efficacy of artemisinin-based combination therapy (ACT) is poorly understood. Methodology: In a prospective longitudinal in vivo study, neutrophil rates were comp...

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Main Authors: Moussa Djimde, Kassoum Kayentao, Japhet Kabalu Tshiongo, Bakary Fofana, Charles Arama, Sodiomon B Sirima, Jean Bosco Ouedraogo, Abdoul Habib Beavogui, Issaka Sagara, Alassane Dicko, Petra F Mens, Henk DFH Schallig, Abdoulaye Djimde
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2023-09-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/17089
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author Moussa Djimde
Kassoum Kayentao
Japhet Kabalu Tshiongo
Bakary Fofana
Charles Arama
Sodiomon B Sirima
Jean Bosco Ouedraogo
Abdoul Habib Beavogui
Issaka Sagara
Alassane Dicko
Petra F Mens
Henk DFH Schallig
Abdoulaye Djimde
author_facet Moussa Djimde
Kassoum Kayentao
Japhet Kabalu Tshiongo
Bakary Fofana
Charles Arama
Sodiomon B Sirima
Jean Bosco Ouedraogo
Abdoul Habib Beavogui
Issaka Sagara
Alassane Dicko
Petra F Mens
Henk DFH Schallig
Abdoulaye Djimde
author_sort Moussa Djimde
collection DOAJ
description Introduction: Polymorphonuclear neutrophils (PMN) are involved in pathogen clearance by phagocytosis. However, the role of PMNs in the efficacy of artemisinin-based combination therapy (ACT) is poorly understood. Methodology: In a prospective longitudinal in vivo study, neutrophil rates were compared with malaria carriage after treatment with different ACTs: Artemether - lumefantrine (AL), Artesunate - amodiaquine (ASAQ), Dihydroartemisinin - piperaquine (DP) or Pyronaridine artesunate (PA). The study cases were classified as having neutropenia, normal neutrophil levels or neutrophilia depending on the level of neutrophils in the blood. This study included 3148 patients and was analyzed using R. Results: On day 7, only four patients in the neutropenia group and treated with AL had a malaria positive blood smear based on microscopy. On day 28, the rate of recurrent parasitemia in the AL arm was significantly higher in neutropenia patients (50.9%) than in patients with normal rates of neutrophils (43.1%) or in those with neutrophilia (6.0%) (p < 0.001). In ASAQ arm, the rate of recurrent Plasmodium falciparum parasitemia was 58.8% in the neutropenia group versus 29.4% in patients with normal rates of neutrophils and 11.8% in patients with neutrophilia (p < 0.001). No patient treated with DP with normal neutrophil counts or neutrophilia was carrying malaria parasites on day 28. Among the 15 patients with parasitemia on day 28 in the PA arm, 11 (73.33%) had neutropenia while 4 (26.67%) had a normal neutrophil count (p < 0.001). Conclusions: Patients with neutropenia had higher rates of recurrent P. falciparum parasitemia after ACT.
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spelling doaj-art-7c99bd971b3b4262b722a98ed75e8f6d2025-08-20T02:16:17ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-09-01170910.3855/jidc.17089Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-AfricaMoussa Djimde0Kassoum Kayentao1Japhet Kabalu Tshiongo2Bakary Fofana3Charles Arama4Sodiomon B Sirima5Jean Bosco Ouedraogo6Abdoul Habib Beavogui7Issaka Sagara8Alassane Dicko9Petra F Mens10Henk DFH Schallig11Abdoulaye Djimde12Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), MaliMalaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), MaliDepartment of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the CongoMalaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), MaliMalaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), MaliGroupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina FasoInstitut des Sciences et des Techniques Bobo Dioulasso (INSTech-Bobo), Burkina FasoCentre National de Formation et de Recherche en Santé Rurale (CNFRSR), Mafinrinha, GuineaMalaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), MaliMalaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), MaliAmsterdam University Medical Centre, Academic Medical Centre at the University of Amsterdam (AMC), Amsterdam, The NetherlandsAmsterdam University Medical Centre, Academic Medical Centre at the University of Amsterdam (AMC), Amsterdam, The NetherlandsMalaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali Introduction: Polymorphonuclear neutrophils (PMN) are involved in pathogen clearance by phagocytosis. However, the role of PMNs in the efficacy of artemisinin-based combination therapy (ACT) is poorly understood. Methodology: In a prospective longitudinal in vivo study, neutrophil rates were compared with malaria carriage after treatment with different ACTs: Artemether - lumefantrine (AL), Artesunate - amodiaquine (ASAQ), Dihydroartemisinin - piperaquine (DP) or Pyronaridine artesunate (PA). The study cases were classified as having neutropenia, normal neutrophil levels or neutrophilia depending on the level of neutrophils in the blood. This study included 3148 patients and was analyzed using R. Results: On day 7, only four patients in the neutropenia group and treated with AL had a malaria positive blood smear based on microscopy. On day 28, the rate of recurrent parasitemia in the AL arm was significantly higher in neutropenia patients (50.9%) than in patients with normal rates of neutrophils (43.1%) or in those with neutrophilia (6.0%) (p < 0.001). In ASAQ arm, the rate of recurrent Plasmodium falciparum parasitemia was 58.8% in the neutropenia group versus 29.4% in patients with normal rates of neutrophils and 11.8% in patients with neutrophilia (p < 0.001). No patient treated with DP with normal neutrophil counts or neutrophilia was carrying malaria parasites on day 28. Among the 15 patients with parasitemia on day 28 in the PA arm, 11 (73.33%) had neutropenia while 4 (26.67%) had a normal neutrophil count (p < 0.001). Conclusions: Patients with neutropenia had higher rates of recurrent P. falciparum parasitemia after ACT. https://jidc.org/index.php/journal/article/view/17089malarianeutrophilsartemisinin-based combination therapyWest Africa
spellingShingle Moussa Djimde
Kassoum Kayentao
Japhet Kabalu Tshiongo
Bakary Fofana
Charles Arama
Sodiomon B Sirima
Jean Bosco Ouedraogo
Abdoul Habib Beavogui
Issaka Sagara
Alassane Dicko
Petra F Mens
Henk DFH Schallig
Abdoulaye Djimde
Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa
Journal of Infection in Developing Countries
malaria
neutrophils
artemisinin-based combination therapy
West Africa
title Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa
title_full Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa
title_fullStr Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa
title_full_unstemmed Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa
title_short Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa
title_sort variation in neutrophil levels and artemisinin based combination therapy efficacy in west africa
topic malaria
neutrophils
artemisinin-based combination therapy
West Africa
url https://jidc.org/index.php/journal/article/view/17089
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