22 results on '"Guthmann, Jean-Paul"'
Search Results
2. The effect of dosing strategies on the therapeutic efficacy of artesunate-amodiaquine for uncomplicated malaria: a meta-analysis of individual patient data.
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WorldWide Antimalarial Resistance Network (WWARN) AS-AQ Study Group, Adjuik, Martin A, Allan, Richard, Anvikar, Anupkumar R, Ashley, Elizabeth A, Ba, Mamadou S, Barennes, Hubert, Barnes, Karen I, Bassat, Quique, Baudin, Elisabeth, Björkman, Anders, Bompart, François, Bonnet, Maryline, Borrmann, Steffen, Brasseur, Philippe, Bukirwa, Hasifa, Checchi, Francesco, Cot, Michel, Dahal, Prabin, D'Alessandro, Umberto, Deloron, Philippe, Desai, Meghna, Diap, Graciela, Djimde, Abdoulaye A, Dorsey, Grant, Doumbo, Ogobara K, Espié, Emmanuelle, Etard, Jean-Francois, Fanello, Caterina I, Faucher, Jean-François, Faye, Babacar, Flegg, Jennifer A, Gaye, Oumar, Gething, Peter W, González, Raquel, Grandesso, Francesco, Guerin, Philippe J, Guthmann, Jean-Paul, Hamour, Sally, Hasugian, Armedy Ronny, Hay, Simon I, Humphreys, Georgina S, Jullien, Vincent, Juma, Elizabeth, Kamya, Moses R, Karema, Corine, Kiechel, Jean R, Kremsner, Peter G, Krishna, Sanjeev, Lameyre, Valérie, Ibrahim, Laminou M, Lee, Sue J, Lell, Bertrand, Mårtensson, Andreas, Massougbodji, Achille, Menan, Hervé, Ménard, Didier, Menéndez, Clara, Meremikwu, Martin, Moreira, Clarissa, Nabasumba, Carolyn, Nambozi, Michael, Ndiaye, Jean-Louis, Nikiema, Frederic, Nsanzabana, Christian, Ntoumi, Francine, Ogutu, Bernhards R, Olliaro, Piero, Osorio, Lyda, Ouédraogo, Jean-Bosco, Penali, Louis K, Pene, Mbaye, Pinoges, Loretxu, Piola, Patrice, Price, Ric N, Roper, Cally, Rosenthal, Philip J, Rwagacondo, Claude Emile, Same-Ekobo, Albert, Schramm, Birgit, Seck, Amadou, Sharma, Bhawna, Sibley, Carol Hopkins, Sinou, Véronique, Sirima, Sodiomon B, Smith, Jeffery J, Smithuis, Frank, Somé, Fabrice A, Sow, Doudou, Staedke, Sarah G, Stepniewska, Kasia, Swarthout, Todd D, Sylla, Khadime, Talisuna, Ambrose O, Tarning, Joel, Taylor, Walter RJ, Temu, Emmanuel A, Thwing, Julie I, Tjitra, Emiliana, and Tine, Roger CK
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WorldWide Antimalarial Resistance Network (WWARN) AS-AQ Study Group ,Humans ,Malaria ,Falciparum ,Recurrence ,Artemisinins ,Amodiaquine ,Drug Combinations ,Antimalarials ,Treatment Outcome ,Risk Factors ,Dose-Response Relationship ,Drug ,Middle Aged ,Africa ,Female ,Male ,Malaria ,Plasmodium falciparum ,Drug resistance ,Artesunate ,Dosing ,Efficacy ,Falciparum ,Dose-Response Relationship ,Drug ,Medical and Health Sciences ,General & Internal Medicine - Abstract
BackgroundArtesunate-amodiaquine (AS-AQ) is one of the most widely used artemisinin-based combination therapies (ACTs) to treat uncomplicated Plasmodium falciparum malaria in Africa. We investigated the impact of different dosing strategies on the efficacy of this combination for the treatment of falciparum malaria.MethodsIndividual patient data from AS-AQ clinical trials were pooled using the WorldWide Antimalarial Resistance Network (WWARN) standardised methodology. Risk factors for treatment failure were identified using a Cox regression model with shared frailty across study sites.ResultsForty-three studies representing 9,106 treatments from 1999-2012 were included in the analysis; 4,138 (45.4%) treatments were with a fixed dose combination with an AQ target dose of 30 mg/kg (FDC), 1,293 (14.2%) with a non-fixed dose combination with an AQ target dose of 25 mg/kg (loose NFDC-25), 2,418 (26.6%) with a non-fixed dose combination with an AQ target dose of 30 mg/kg (loose NFDC-30), and the remaining 1,257 (13.8%) with a co-blistered non-fixed dose combination with an AQ target dose of 30 mg/kg (co-blistered NFDC). The median dose of AQ administered was 32.1 mg/kg [IQR: 25.9-38.2], the highest dose being administered to patients treated with co-blistered NFDC (median = 35.3 mg/kg [IQR: 30.6-43.7]) and the lowest to those treated with loose NFDC-25 (median = 25.0 mg/kg [IQR: 22.7-25.0]). Patients treated with FDC received a median dose of 32.4 mg/kg [IQR: 27-39.0]. After adjusting for reinfections, the corrected antimalarial efficacy on day 28 after treatment was similar for co-blistered NFDC (97.9% [95% confidence interval (CI): 97.0-98.8%]) and FDC (98.1% [95% CI: 97.6%-98.5%]; P = 0.799), but significantly lower for the loose NFDC-25 (93.4% [95% CI: 91.9%-94.9%]), and loose NFDC-30 (95.0% [95% CI: 94.1%-95.9%]) (P
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- 2015
3. A cluster of multidrug-resistant Mycobacterium tuberculosis among patients arriving in Europe from the Horn of Africa: a molecular epidemiological study
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Avsar, Korkut, Bauer, Christoph, Bernasconi, Enos, Borroni, Emanuele, Brusin, Sergio, Coscollá Dévis, Mireia, Crook, Derrick W., Dedicoat, Martin, Fitzgibbon, Margaret, Gagneux, Sébastien, Geiger, Francisca, Guthmann, Jean-Paul, Hendrickx, David, Hoffmann-Thiel, Sabine, van Ingen, Jakko, Jackson, Sarah, Jaton, Katia, Lange, Christoph, Mazza Stalder, Jessica, O'Donnell, Joan, Opota, Onya, Peto, Tim E.A., Preiswerk, Benjamin, Roycroft, Emma, Sato, Mariko, Schacher, Regina, Schulthess, Bettina, Smith, E. Grace, Soini, Hanna, Sougakoff, Wladimir, Tagliani, Elisa, Utpatel, Christian, Veziris, Nicolas, Wagner-Wiening, Christiane, Witschi, Mark, Walker, Timothy M, Merker, Matthias, Knoblauch, Astrid M, Helbling, Peter, Schoch, Otto D, van der Werf, Marieke J, Kranzer, Katharina, Fiebig, Lena, Kröger, Stefan, Haas, Walter, Hoffmann, Harald, Indra, Alexander, Egli, Adrian, Cirillo, Daniela M, Robert, Jérôme, Rogers, Thomas R, Groenheit, Ramona, Mengshoel, Anne T, Mathys, Vanessa, Haanperä, Marjo, Soolingen, Dick van, Niemann, Stefan, Böttger, Erik C, and Keller, Peter M
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- 2018
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4. Active tuberculosis screening among the displaced population fleeing Ukraine, France, February to October 2022
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Guthmann, Jean-Paul, primary, Fraisse, Philippe, additional, Bonnet, Isabelle, additional, and Robert, Jérôme, additional
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- 2023
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5. Tuberculosis incidence in foreign-born people residing in European countries in 2020
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Vasiliu, Anca, Köhler, Niklas, Altpeter, Ekkehardt, Ægisdóttir, Tinna Rán, Amerali, Marina, de Oñate, Wouter Arrazola, Bakos, Ágnes, D'Amato, Stefania, Cirillo, Daniela Maria, van Crevel, Reinout, Davidaviciene, Edita, Demuth, Irène, Domínguez, Jose, Duarte, Raquel, Günther, Gunar, Guthmann, Jean-Paul, Hatzianastasiou, Sophia, Holm, Louise Hedevang, Herrador, Zaida, Hribar, Urška, Huberty, Conny, Ibraim, Elmira, Jackson, Sarah, Jensenius, Mogens, Josefsdottir, Kamilla Sigridur, Koch, Anders, Korzeniewska-Kosela, Maria, Kuksa, Liga, Kunst, Heinke, Lienhardt, Christian, Mahler, Beatrice, Makek, Mateja Janković, Muylle, Inge, Normark, Johan, Pace-Asciak, Analita, Petrović, Goranka, Pieridou, Despo, Russo, Giulia, Rzhepishevska, Olena, Salzer, Helmut J. F., Marques, Marta Sá, Schmid, Daniela, Solovic, Ivan, Sukholytka, Mariya, Svetina, Petra, Tyufekchieva, Mariya, Vasankari, Tuula, Viiklepp, Piret, Villand, Kersti, Wallenfels, Jiri, Wesolowski, Stefan, Mandalakas, Anna-Maria, Martinez, Leonardo, Zenner, Dominik, Lange, Christoph, Vasiliu, Anca, Köhler, Niklas, Altpeter, Ekkehardt, Ægisdóttir, Tinna Rán, Amerali, Marina, de Oñate, Wouter Arrazola, Bakos, Ágnes, D'Amato, Stefania, Cirillo, Daniela Maria, van Crevel, Reinout, Davidaviciene, Edita, Demuth, Irène, Domínguez, Jose, Duarte, Raquel, Günther, Gunar, Guthmann, Jean-Paul, Hatzianastasiou, Sophia, Holm, Louise Hedevang, Herrador, Zaida, Hribar, Urška, Huberty, Conny, Ibraim, Elmira, Jackson, Sarah, Jensenius, Mogens, Josefsdottir, Kamilla Sigridur, Koch, Anders, Korzeniewska-Kosela, Maria, Kuksa, Liga, Kunst, Heinke, Lienhardt, Christian, Mahler, Beatrice, Makek, Mateja Janković, Muylle, Inge, Normark, Johan, Pace-Asciak, Analita, Petrović, Goranka, Pieridou, Despo, Russo, Giulia, Rzhepishevska, Olena, Salzer, Helmut J. F., Marques, Marta Sá, Schmid, Daniela, Solovic, Ivan, Sukholytka, Mariya, Svetina, Petra, Tyufekchieva, Mariya, Vasankari, Tuula, Viiklepp, Piret, Villand, Kersti, Wallenfels, Jiri, Wesolowski, Stefan, Mandalakas, Anna-Maria, Martinez, Leonardo, Zenner, Dominik, and Lange, Christoph
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Background: European-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening. Aim: We aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening. Methods: The Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin. Results: Data on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea. Conclusions: Country of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks.
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- 2023
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6. Prise en charge thérapeutique des tuberculoses résistantes
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Revest, Matthieu, primary, Veziris, Nicolas, additional, Guthmann, Jean-Paul, additional, Gugliemetti, Lorenzo, additional, Ader, Florence, additional, Rioux, Christophe, additional, Pourcher, Valérie, additional, Aubry, Alexandra, additional, and Robert, Jérôme, additional
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- 2022
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7. Diphtheria-Tetanus-Polio, Measles-Mumps-Rubella, and Hepatitis B Vaccination Coverage and Associated Factors among Homeless Children in the Paris Region in 2013: Results from the ENFAMS Survey
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Mansor-Lefebvre, Samreen, primary, Le Strat, Yann, additional, Bernadou, Anne, additional, Vignier, Nicolas, additional, Guthmann, Jean-Paul, additional, Arnaud, Amandine, additional, Lévy-Bruhl, Daniel, additional, and Vandentorren, Stéphanie, additional
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- 2020
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8. Tuberculosis treatment outcomes of notified cases: trends and determinants of potential unfavourable outcome, France, 2008 to 2014
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Guthmann, Jean-Paul, primary, Léon, Lucie, additional, Antoine, Delphine, additional, and Lévy-Bruhl, Daniel, additional
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- 2020
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9. Tuberculosis in the European Union/European Economic Area: much progress, still many challenges
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Guthmann, Jean-Paul, primary and Haas, Walter, additional
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- 2019
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10. A cluster of multidrug-resistant Mycobacterium tuberculosis among patients arriving in Europe from the Horn of Africa: a molecular epidemiological study
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Walker, Timothy M, primary, Merker, Matthias, additional, Knoblauch, Astrid M, additional, Helbling, Peter, additional, Schoch, Otto D, additional, van der Werf, Marieke J, additional, Kranzer, Katharina, additional, Fiebig, Lena, additional, Kröger, Stefan, additional, Haas, Walter, additional, Hoffmann, Harald, additional, Indra, Alexander, additional, Egli, Adrian, additional, Cirillo, Daniela M, additional, Robert, Jérôme, additional, Rogers, Thomas R, additional, Groenheit, Ramona, additional, Mengshoel, Anne T, additional, Mathys, Vanessa, additional, Haanperä, Marjo, additional, Soolingen, Dick van, additional, Niemann, Stefan, additional, Böttger, Erik C, additional, Keller, Peter M, additional, Avsar, Korkut, additional, Bauer, Christoph, additional, Bernasconi, Enos, additional, Borroni, Emanuele, additional, Brusin, Sergio, additional, Coscollá Dévis, Mireia, additional, Crook, Derrick W., additional, Dedicoat, Martin, additional, Fitzgibbon, Margaret, additional, Gagneux, Sébastien, additional, Geiger, Francisca, additional, Guthmann, Jean-Paul, additional, Hendrickx, David, additional, Hoffmann-Thiel, Sabine, additional, van Ingen, Jakko, additional, Jackson, Sarah, additional, Jaton, Katia, additional, Lange, Christoph, additional, Mazza Stalder, Jessica, additional, O'Donnell, Joan, additional, Opota, Onya, additional, Peto, Tim E.A., additional, Preiswerk, Benjamin, additional, Roycroft, Emma, additional, Sato, Mariko, additional, Schacher, Regina, additional, Schulthess, Bettina, additional, Smith, E. Grace, additional, Soini, Hanna, additional, Sougakoff, Wladimir, additional, Tagliani, Elisa, additional, Utpatel, Christian, additional, Veziris, Nicolas, additional, Wagner-Wiening, Christiane, additional, and Witschi, Mark, additional
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- 2018
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11. In Vivo Parasitological Measures of Artemisinin Susceptibility
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Stepniewska, Kasia, Ashley, Elizabeth, Lee, Sue J., Anstey, Nicholas, Barnes, Karen I., Binh, Tran Quang, D'Alessandro, Umberto, Day, Nicholas P. J., de Vries, Peter J., Dorsey, Grant, Guthmann, Jean-Paul, Mayxay, Mayfong, Newton, Paul N., Olliaro, Piero, Osorio, Lyda, Price, Ric N., Rowland, Mark, Smithuis, Frank, Taylor, Walter R. J., Nosten, François, White, Nicholas J., Stepniewska, Kasia, Ashley, Elizabeth, Lee, Sue J., Anstey, Nicholas, Barnes, Karen I., Binh, Tran Quang, D'Alessandro, Umberto, Day, Nicholas P. J., de Vries, Peter J., Dorsey, Grant, Guthmann, Jean-Paul, Mayxay, Mayfong, Newton, Paul N., Olliaro, Piero, Osorio, Lyda, Price, Ric N., Rowland, Mark, Smithuis, Frank, Taylor, Walter R. J., Nosten, François, and White, Nicholas J.
- Abstract
Parasite clearance data from 18,699 patients with falciparum malaria treated with an artemisinin derivative in areas of low (n = 14,539), moderate (n = 2077), and high (n = 2083) levels of malaria transmission across the world were analyzed to determine the factors that affect clearance rates and identify a simple in vivo screening measure for artemisinin resistance. The main factor affecting parasite clearance time was parasite density on admission. Clearance rates were faster in high-transmission settings and with more effective partner drugs in artemisinin-based combination treatments (ACTs). The result of the malaria blood smear on day 3 (72 h) was a good predictor of subsequent treatment failure and provides a simple screening measure for artemisinin resistance. Artemisinin resistance is highly unlikely if the proportion of patients with parasite densities of <100,000 parasites/µL given the currently recommended 3-day ACT who have a positive smear result on day 3 is <3%; that is, for n patients the observed number with a positive smear result on day 3 does not exceed (n + 60)/24
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- 2017
12. Baseline data of parasite clearance in patients with falciparum malaria treated with an artemisinin derivative : an individual patient data meta-analysis
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WWARN Parasite Clearance Study Group, Abdulla, Salim, Ashley, Elizabeth A, Bassat, Quique, Bethell, Delia, Björkman, Anders, Borrmann, Steffen, D'Alessandro, Umberto, Dahal, Prabin, Day, Nicholas P, Diakite, Mahamadou, Djimde, Abdoulaye A, Dondorp, Arjen M, Duong, Socheat, Edstein, Michael D, Fairhurst, Rick M, Faiz, M Abul, Falade, Catherine, Flegg, Jennifer A, Fogg, Carole, Gonzalez, Raquel, Greenwood, Brian, Guérin, Philippe J, Guthmann, Jean-Paul, Hamed, Kamal, Hien, Tran Tinh, Htut, Ye, Juma, Elizabeth, Lim, Pharath, Mårtensson, Andreas, Mayxay, Mayfong, Mokuolu, Olugbenga A, Moreira, Clarissa, Newton, Paul, Noedl, Harald, Nosten, Francois, Ogutu, Bernhards R, Onyamboko, Marie A, Owusu-Agyei, Seth, Phyo, Aung Pyae, Premji, Zul, Price, Ric N, Pukrittayakamee, Sasithon, Ramharter, Michael, Sagara, Issaka, Se, Youry, Suon, Seila, Stepniewska, Kasia, Ward, Stephen A, White, Nicholas J, and Winstanley, Peter A
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Male ,Artemether/lumefantrine ,Social and Clinical Pharmacy ,Drug Resistance ,Physiology ,Parasitemia ,Drug resistance ,chemistry.chemical_compound ,Medicine ,Parasite hosting ,Artemisinin ,Malaria, Falciparum ,Child ,Diagnosis & treatment ,Clinical Trials as Topic ,Surveillance, monitoring, evaluation ,biology ,Public Health, Global Health, Social Medicine and Epidemiology ,Middle Aged ,Artemisinins ,3. Good health ,Infectious Diseases ,Blood ,Artemisinin resistance ,Child, Preschool ,Female ,medicine.drug ,Adult ,endocrine system ,Adolescent ,Plasmodium falciparum ,Antimalarials ,Young Adult ,Health Sciences ,parasitic diseases ,Animals ,Humans ,Aged ,Parasite clearance ,business.industry ,Research ,Samhällsfarmaci och klinisk farmaci ,Infant ,medicine.disease ,biology.organism_classification ,Malaria ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,chemistry ,Artesunate ,Immunology ,Parasitology ,business - Abstract
Background Artemisinin resistance in Plasmodium falciparum manifests as slow parasite clearance but this measure is also influenced by host immunity, initial parasite biomass and partner drug efficacy. This study collated data from clinical trials of artemisinin derivatives in falciparum malaria with frequent parasite counts to provide reference parasite clearance estimates stratified by location, treatment and time, to examine host factors affecting parasite clearance, and to assess the relationships between parasite clearance and risk of recrudescence during follow-up. Methods Data from 24 studies, conducted from 1996 to 2013, with frequent parasite counts were pooled. Parasite clearance half-life (PC1/2) was estimated using the WWARN Parasite Clearance Estimator. Random effects regression models accounting for study and site heterogeneity were used to explore factors affecting PC1/2 and risk of recrudescence within areas with reported delayed parasite clearance (western Cambodia, western Thailand after 2000, southern Vietnam, southern Myanmar) and in all other areas where parasite populations are artemisinin sensitive. Results PC1/2 was estimated in 6975 patients, 3288 of whom also had treatment outcomes evaluate d during 28–63 days follow-up, with 93 (2.8 %) PCR-confirmed recrudescences. In areas with artemisinin-sensitive parasites, the median PC1/2 following three-day artesunate treatment (4 mg/kg/day) ranged from 1.8 to 3.0 h and the proportion of patients with PC1/2 >5 h from 0 to 10 %. Artesunate doses of 4 mg/kg/day decreased PC1/2 by 8.1 % (95 % CI 3.2–12.6) compared to 2 mg/kg/day, except in populations with delayed parasite clearance. PC1/2 was longer in children and in patients with fever or anaemia at enrolment. Long PC1/2 (HR = 2.91, 95 % CI 1.95–4.34 for twofold increase, p
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- 2015
13. Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data
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Abdulla, Salim, Adam, Ishag, Adjei, George O., Adjuik, Martin A., Alemayehu, Bereket, Allan, Richard, Arinaitwe, Emmanuel, Ashley, Elizabeth A., Ba, Mamadou S., Barennes, Hubert, Barnes, Karen I., Bassat, Quique, Baudin, Elisabeth, Berens-Riha, Nicole, Bjoerkman, Anders, Bompart, Francois, Bonnet, Maryline, Borrmann, Steffen, Bousema, Teun, Brasseur, Philippe, Bukirwa, Hasifa, Checchi, Francesco, Dahal, Prabin, D'Alessandro, Umberto, Desai, Meghna, Dicko, Alassane, Djimde, Abdoulaye A., Dorsey, Grant, Doumbo, Ogobara K., Drakeley, Chris J., Duparc, Stephan, Eshetu, Teferi, Espie, Emmanuelle, Etard, Jean-Francois, Faiz, Abul M., Falade, Catherine O., Fanello, Caterina I., Faucher, Jean-Francois, Faye, Babacar, Faye, Oumar, Filler, Scott, Flegg, Jennifer A., Fofana, Bakary, Fogg, Carole, Gadalla, Nahla B., Gaye, Oumar, Genton, Blaise, Gething, Peter W., Gil, Jose P., Gonzalez, Raquel, Grandesso, Francesco, Greenhouse, Bryan, Greenwood, Brian, Grivoyannis, Anastasia, Guerin, Philippe J., Guthmann, Jean-Paul, Hamed, Kamal, Hamour, Sally, Hay, Simon I., Hodel, Eva Maria, Humphreys, Georgina S., Hwang, Jimee, Ibrahim, Maman L., Jima, Daddi, Jones, Joel J., Jullien, Vincent, Juma, Elizabeth, Kachur, Patrick S., Kager, Piet A., Kamugisha, Erasmus, Kamya, Moses R., Karema, Corine, Kayentao, Kassoum, Kiechel, Jean-Rene, Kironde, Fred, Kofoed, Poul-Erik, Kremsner, Peter G., Krishna, Sanjeev, Lameyre, Valerie, Lell, Bertrand, Lima, Angeles, Makanga, Michael, Malik, ElFatih M., Marsh, Kevin, Martensson, Andreas, Massougbodji, Achille, Menan, Herve, Menard, Didier, Menendez, Clara, Mens, Petra F., Meremikwu, Martin, Moreira, Clarissa, Nabasumba, Carolyn, Nambozi, Michael, Ndiaye, Jean-Louis, Ngasala, Billy E., Nikiema, Frederic, Nsanzabana, Christian, Ntoumi, Francine, Oguike, Mary, Ogutu, Bernhards R., Olliaro, Piero, Omar, Sabah A., Ouedraogo, Jean-Bosco, Owusu-Agyei, Seth, Penali, Louis K., Pene, Mbaye, Peshu, Judy, Piola, Patrice, Plowe, Christopher V., Premji, Zul, Price, Ric N., Randrianarivelojosia, Milijaona, Rombo, Lars, Roper, Cally, Rosenthal, Philip J., Sagara, Issaka, Same-Ekobo, Albert, Sawa, Patrick, Schallig, Henk D. F. H., Schramm, Birgit, Seck, Amadou, Shekalaghe, Seif A., Sibley, Carol H., Sinou, Vronique, Sirima, Sodiomon B., Som, Fabrice A., Sow, Doudou, Staedke, Sarah G., Stepniewska, Kasia, Sutherland, Colin J., Swarthout, Todd D., Sylla, Khadime, Talisuna, Ambrose O., Taylor, Walter R. J., Temu, Emmanuel A., Thwing, Julie I., Tine, Roger C. K., Tinto, Halidou, Tommasini, Silva, Toure, Offianan A., Ursing, Johan, Vaillant, Michel T., Valentini, Giovanni, Van den Broek, Ingrid, Van Vugt, Michele, Ward, Stephen A., Winstanley, Peter A., Yavo, William, Yeka, Adoke, Zolia, Yah M., Zongo, Issaka, and WWARN Artemisinin based Combination Therapy (ACT) Africa Baseline Study Group
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parasitic diseases - Abstract
BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P 37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine). CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.
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- 2015
14. Incidence, severity and treatment outcome of tuberculosis in the era of the COVID-19 pandemic, France, 2018-2023
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Guthmann, Jean-Paul, Robert, Jérôme, Viriot, Delphine, and Parent du Chatelet, Isabelle
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•High quality and complete data are necessary to describe trends of tuberculosis epidemiology and assess how these trends may vary as a consequence of external events such as the COVID-19 pandemic;•Discussing reasons why specific social and medical interventions might have impacted the incidence of TB should help to organise and better manage health system disruptions in case of new crisis onset;•Tuberculosis is still an important public health problem in special groups of the EU population such as immigrants and homeless persons and should deserve significant efforts in order to meet the WHO targets of TB elimination;•Documenting treatment outcome deserves a major attention in countries where this information is largely missing, such as in France.
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- 2024
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15. Réseau de surveillance de la couverture vaccinale et des conditions d’immunisation du personnel des établissements de santé : pourquoi, comment
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Floret, Nathalie, primary, Abiteboul, Dominique, additional, Bouvet, Elisabeth, additional, Gehanno, Jean-François, additional, Guthmann, Jean-Paul, additional, Koeck, Jean-Louis, additional, Launay, Odile, additional, Lecieux, Fabienne, additional, L’heriteau, François, additional, Rabaud, Christian, additional, Rolland, Patrick, additional, Touche, Sylvie, additional, and Verdun-Esquer, Catherine, additional
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- 2016
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16. Baseline data of parasite clearance in patients with falciparum malaria treated with an artemisinin derivative : an individual patient data meta-analysis
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Abdulla, Salim, Ashley, Elizabeth A., Bassat, Quique, Bethell, Delia, Bjorkman, Anders, Borrmann, Steffen, D'Alessandro, Umberto, Dahal, Prabin, Day, Nicholas P., Diakite, Mahamadou, Djimde, Abdoulaye A., Dondorp, Arjen M., Duong, Socheat, Edstein, Michael D., Fairhurst, Rick M., Faiz, M. Abul, Falade, Catherine, Flegg, Jennifer A., Fogg, Carole, Gonzalez, Raquel, Greenwood, Brian, Guerin, Philippe J., Guthmann, Jean-Paul, Hamed, Kamal, Hien, Tran Tinh, Htut, Ye, Juma, Elizabeth, Lim, Pharath, Mårtensson, Andreas, Mayxay, Mayfong, Mokuolu, Olugbenga A., Moreira, Clarissa, Newton, Paul, Noedl, Harald, Nosten, Francois, Ogutu, Bernhards R., Onyamboko, Marie A., Owusu-Agyei, Seth, Phyo, Aung Pyae, Premji, Zul, Price, Ric N., Pukrittayakamee, Sasithon, Ramharter, Michael, Sagara, Issaka, Se, Youry, Suon, Seila, Stepniewska, Kasia, Ward, Stephen A., White, Nicholas J., Winstanley, Peter A., Abdulla, Salim, Ashley, Elizabeth A., Bassat, Quique, Bethell, Delia, Bjorkman, Anders, Borrmann, Steffen, D'Alessandro, Umberto, Dahal, Prabin, Day, Nicholas P., Diakite, Mahamadou, Djimde, Abdoulaye A., Dondorp, Arjen M., Duong, Socheat, Edstein, Michael D., Fairhurst, Rick M., Faiz, M. Abul, Falade, Catherine, Flegg, Jennifer A., Fogg, Carole, Gonzalez, Raquel, Greenwood, Brian, Guerin, Philippe J., Guthmann, Jean-Paul, Hamed, Kamal, Hien, Tran Tinh, Htut, Ye, Juma, Elizabeth, Lim, Pharath, Mårtensson, Andreas, Mayxay, Mayfong, Mokuolu, Olugbenga A., Moreira, Clarissa, Newton, Paul, Noedl, Harald, Nosten, Francois, Ogutu, Bernhards R., Onyamboko, Marie A., Owusu-Agyei, Seth, Phyo, Aung Pyae, Premji, Zul, Price, Ric N., Pukrittayakamee, Sasithon, Ramharter, Michael, Sagara, Issaka, Se, Youry, Suon, Seila, Stepniewska, Kasia, Ward, Stephen A., White, Nicholas J., and Winstanley, Peter A.
- Abstract
Background: Artemisinin resistance in Plasmodium falciparum manifests as slow parasite clearance but this measure is also influenced by host immunity, initial parasite biomass and partner drug efficacy. This study collated data from clinical trials of artemisinin derivatives in falciparum malaria with frequent parasite counts to provide reference parasite clearance estimates stratified by location, treatment and time, to examine host factors affecting parasite clearance, and to assess the relationships between parasite clearance and risk of recrudescence during follow-up. Methods: Data from 24 studies, conducted from 1996 to 2013, with frequent parasite counts were pooled. Parasite clearance half-life (PC1/2) was estimated using the WWARN Parasite Clearance Estimator. Random effects regression models accounting for study and site heterogeneity were used to explore factors affecting PC1/2 and risk of recrudescence within areas with reported delayed parasite clearance (western Cambodia, western Thailand after 2000, southern Vietnam, southern Myanmar) and in all other areas where parasite populations are artemisinin sensitive. Results: PC1/2 was estimated in 6975 patients, 3288 of whom also had treatment outcomes evaluate d during 28-63 days follow-up, with 93 (2.8 %) PCR-confirmed recrudescences. In areas with artemisinin-sensitive parasites, the median PC1/2 following three-day artesunate treatment (4 mg/kg/day) ranged from 1.8 to 3.0 h and the proportion of patients with PC1/2 > 5 h from 0 to 10 %. Artesunate doses of 4 mg/kg/day decreased PC1/2 by 8.1 % (95 % CI 3.2-12.6) compared to 2 mg/kg/day, except in populations with delayed parasite clearance. PC1/2 was longer in children and in patients with fever or anaemia at enrolment. Long PC1/2 (HR = 2.91, 95 % CI 1.95-4.34 for twofold increase, p < 0.001) and high initial parasitaemia (HR = 2.23, 95 % CI 1.44-3.45 for tenfold increase, p < 0.001) were associated independently with an increased risk of recrude
- Published
- 2015
- Full Text
- View/download PDF
17. The effect of dosing strategies on the therapeutic efficacy of artesunate-amodiaquine for uncomplicated malaria : a meta-analysis of individual patient data
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Adjuik, Martin A., Allan, Richard, Anvikar, Anupkumar R., Ashley, Elizabeth A., Ba, Mamadou S., Barennes, Hubert, Barnes, Karen I., Bassat, Quique, Baudin, Elisabeth, Bjorkman, Anders, Bompart, Francois, Bonnet, Maryline, Borrmann, Steffen, Brasseur, Philippe, Bukirwa, Hasifa, Checchi, Francesco, Cot, Michel, Dahal, Prabin, D'Alessandro, Umberto, Deloron, Philippe, Desai, Meghna, Diap, Graciela, Djimde, Abdoulaye A., Dorsey, Grant, Doumbo, Ogobara K., Espie, Emmanuelle, Etard, Jean-Francois, Fanello, Caterina I., Faucher, Jean-Francois, Faye, Babacar, Flegg, Jennifer A., Gaye, Oumar, Gething, Peter W., Gonzalez, Raquel, Grandesso, Francesco, Guerin, Philippe J., Guthmann, Jean-Paul, Hamour, Sally, Hasugian, Armedy Ronny, Hay, Simon I., Humphreys, Georgina S., Jullien, Vincent, Juma, Elizabeth, Kamya, Moses R., Karema, Corine, Kiechel, Jean R., Kremsner, Peter G., Krishna, Sanjeev, Lameyre, Valerie, Ibrahim, Laminou M., Lee, Sue J., Lell, Bertrand, Martensson, Andreas, Massougbodji, Achille, Menan, Herve, Menard, Didier, Menendez, Clara, Meremikwu, Martin, Moreira, Clarissa, Nabasumba, Carolyn, Nambozi, Michael, Ndiaye, Jean-Louis, Nikiema, Frederic, Nsanzabana, Christian, Ntoumi, Francine, Ogutu, Bernhards R., Olliaro, Piero, Osorio, Lyda, Ouedraogo, Jean-Bosco, Penali, Louis K., Pene, Mbaye, Pinoges, Loretxu, Piola, Patrice, Price, Ric N., Roper, Cally, Rosenthal, Philip J., Rwagacondo, Claude Emile, Same-Ekobo, Albert, Schramm, Birgit, Seck, Amadou, Sharma, Bhawna, Sibley, Carol Hopkins, Sinou, Veronique, Sirima, Sodiomon B., Smith, Jeffery J., Smithuis, Frank, Some, Fabrice A., Sow, Doudou, Staedke, Sarah G., Stepniewska, Kasia, Swarthout, Todd D., Sylla, Khadime, Talisuna, Ambrose O., Tarning, Joel, Taylor, Walter R. J., Temu, Emmanuel A., Thwing, Julie I., Tjitra, Emiliana, Tine, Roger C. K., Tinto, Halidou, Vaillant, Michel T., Valecha, Neena, Van den Broek, Ingrid, White, Nicholas J., Yeka, Adoke, Zongo, Issaka, Adjuik, Martin A., Allan, Richard, Anvikar, Anupkumar R., Ashley, Elizabeth A., Ba, Mamadou S., Barennes, Hubert, Barnes, Karen I., Bassat, Quique, Baudin, Elisabeth, Bjorkman, Anders, Bompart, Francois, Bonnet, Maryline, Borrmann, Steffen, Brasseur, Philippe, Bukirwa, Hasifa, Checchi, Francesco, Cot, Michel, Dahal, Prabin, D'Alessandro, Umberto, Deloron, Philippe, Desai, Meghna, Diap, Graciela, Djimde, Abdoulaye A., Dorsey, Grant, Doumbo, Ogobara K., Espie, Emmanuelle, Etard, Jean-Francois, Fanello, Caterina I., Faucher, Jean-Francois, Faye, Babacar, Flegg, Jennifer A., Gaye, Oumar, Gething, Peter W., Gonzalez, Raquel, Grandesso, Francesco, Guerin, Philippe J., Guthmann, Jean-Paul, Hamour, Sally, Hasugian, Armedy Ronny, Hay, Simon I., Humphreys, Georgina S., Jullien, Vincent, Juma, Elizabeth, Kamya, Moses R., Karema, Corine, Kiechel, Jean R., Kremsner, Peter G., Krishna, Sanjeev, Lameyre, Valerie, Ibrahim, Laminou M., Lee, Sue J., Lell, Bertrand, Martensson, Andreas, Massougbodji, Achille, Menan, Herve, Menard, Didier, Menendez, Clara, Meremikwu, Martin, Moreira, Clarissa, Nabasumba, Carolyn, Nambozi, Michael, Ndiaye, Jean-Louis, Nikiema, Frederic, Nsanzabana, Christian, Ntoumi, Francine, Ogutu, Bernhards R., Olliaro, Piero, Osorio, Lyda, Ouedraogo, Jean-Bosco, Penali, Louis K., Pene, Mbaye, Pinoges, Loretxu, Piola, Patrice, Price, Ric N., Roper, Cally, Rosenthal, Philip J., Rwagacondo, Claude Emile, Same-Ekobo, Albert, Schramm, Birgit, Seck, Amadou, Sharma, Bhawna, Sibley, Carol Hopkins, Sinou, Veronique, Sirima, Sodiomon B., Smith, Jeffery J., Smithuis, Frank, Some, Fabrice A., Sow, Doudou, Staedke, Sarah G., Stepniewska, Kasia, Swarthout, Todd D., Sylla, Khadime, Talisuna, Ambrose O., Tarning, Joel, Taylor, Walter R. J., Temu, Emmanuel A., Thwing, Julie I., Tjitra, Emiliana, Tine, Roger C. K., Tinto, Halidou, Vaillant, Michel T., Valecha, Neena, Van den Broek, Ingrid, White, Nicholas J., Yeka, Adoke, and Zongo, Issaka
- Abstract
Background: Artesunate-amodiaquine (AS-AQ) is one of the most widely used artemisinin-based combination therapies (ACTs) to treat uncomplicated Plasmodium falciparum malaria in Africa. We investigated the impact of different dosing strategies on the efficacy of this combination for the treatment of falciparum malaria. Methods: Individual patient data from AS-AQ clinical trials were pooled using the WorldWide Antimalarial Resistance Network (WWARN) standardised methodology. Risk factors for treatment failure were identified using a Cox regression model with shared frailty across study sites. Results: Forty-three studies representing 9,106 treatments from 1999-2012 were included in the analysis; 4,138 (45.4%) treatments were with a fixed dose combination with an AQ target dose of 30 mg/kg (FDC), 1,293 (14.2%) with a non-fixed dose combination with an AQ target dose of 25 mg/kg (loose NFDC-25), 2,418 (26.6%) with a non-fixed dose combination with an AQ target dose of 30 mg/kg (loose NFDC-30), and the remaining 1,257 (13.8%) with a co-blistered non-fixed dose combination with an AQ target dose of 30 mg/kg (co-blistered NFDC). The median dose of AQ administered was 32.1 mg/kg [IQR: 25.9-38.2], the highest dose being administered to patients treated with co-blistered NFDC (median = 35.3 mg/kg [IQR: 30.6-43.7]) and the lowest to those treated with loose NFDC-25 (median = 25.0 mg/kg [IQR: 22.7-25.0]). Patients treated with FDC received a median dose of 32.4 mg/kg [IQR: 27-39.0]. After adjusting for reinfections, the corrected antimalarial efficacy on day 28 after treatment was similar for co-blistered NFDC (97.9% [95% confidence interval (CI): 97.0-98.8%]) and FDC (98.1% [95% CI: 97.6%-98.5%]; P = 0.799), but significantly lower for the loose NFDC-25 (93.4% [95% CI: 91.9%-94.9%]), and loose NFDC-30 (95.0% [95% CI: 94.1%-95.9%]) (P < 0.001 for all comparisons). After controlling for age, AQ dose, baseline parasitemia and region; treatment with loose NFDC-25 was associated
- Published
- 2015
- Full Text
- View/download PDF
18. The use of reimbursement data for timely monitoring of vaccination coverage: the example of human papillomavirus vaccine following public concerns about vaccine safety
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Fonteneau, Laure, primary, Ragot, Marine, additional, Parent du Châtelet, Isabelle, additional, Guthmann, Jean-Paul, additional, and Lévy-Bruhl, Daniel, additional
- Published
- 2015
- Full Text
- View/download PDF
19. An unusual outbreak of parvovirus B19 infections, France, 2023 to 2024.
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d'Humières C, Fouillet A, Verdurme L, Lakoussan SB, Gallien Y, Coignard C, Hervo M, Ebel A, Soares A, Visseaux B, Maire B, Juan PH, Parent du Châtelet I, Guthmann JP, and Durand J
- Subjects
- Humans, France epidemiology, Adult, Female, Male, Child, Adolescent, Child, Preschool, Middle Aged, Antibodies, Viral blood, Erythema Infectiosum epidemiology, Erythema Infectiosum diagnosis, Young Adult, Infant, Aged, Parvovirus B19, Human isolation & purification, Disease Outbreaks, Parvoviridae Infections epidemiology, Parvoviridae Infections diagnosis, Immunoglobulin M blood
- Abstract
From April 2023 to May 2024, an unusual epidemic of parvovirus B19 (B19V) infections occurred in France. The number of B19V IgM-positive serologies was four times higher than in the previous epidemic in 2019. Clinical data from emergency networks corroborated this observation. Morbidity and mortality consequences were observed in children through all data sources. In adults, the increase was only observed in laboratory-confirmed data. Physicians and decisionmakers should be informed in order to better prevent, diagnose and manage at-risk patients.
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- 2024
- Full Text
- View/download PDF
20. Tuberculosis incidence in foreign-born people residing in European countries in 2020.
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Vasiliu A, Köhler N, Altpeter E, Ægisdóttir TR, Amerali M, de Oñate WA, Bakos Á, D'Amato S, Cirillo DM, van Crevel R, Davidaviciene E, Demuth I, Domínguez J, Duarte R, Günther G, Guthmann JP, Hatzianastasiou S, Holm LH, Herrador Z, Hribar U, Huberty C, Ibraim E, Jackson S, Jensenius M, Josefsdottir KS, Koch A, Korzeniewska-Kosela M, Kuksa L, Kunst H, Lienhardt C, Mahler B, Makek MJ, Muylle I, Normark J, Pace-Asciak A, Petrović G, Pieridou D, Russo G, Rzhepishevska O, Salzer HJF, Marques MS, Schmid D, Solovic I, Sukholytka M, Svetina P, Tyufekchieva M, Vasankari T, Viiklepp P, Villand K, Wallenfels J, Wesolowski S, Mandalakas AM, Martinez L, Zenner D, and Lange C
- Subjects
- Humans, Incidence, Cross-Sectional Studies, Somalia, Europe epidemiology, Tuberculosis diagnosis, Tuberculosis epidemiology
- Abstract
BackgroundEuropean-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening.AimWe aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening.MethodsThe Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin.ResultsData on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea.ConclusionsCountry of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks.
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- 2023
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21. Baseline data of parasite clearance in patients with falciparum malaria treated with an artemisinin derivative: an individual patient data meta-analysis.
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Abdulla S, Ashley EA, Bassat Q, Bethell D, Björkman A, Borrmann S, D'Alessandro U, Dahal P, Day NP, Diakite M, Djimde AA, Dondorp AM, Duong S, Edstein MD, Fairhurst RM, Faiz MA, Falade C, Flegg JA, Fogg C, Gonzalez R, Greenwood B, Guérin PJ, Guthmann JP, Hamed K, Hien TT, Htut Y, Juma E, Lim P, Mårtensson A, Mayxay M, Mokuolu OA, Moreira C, Newton P, Noedl H, Nosten F, Ogutu BR, Onyamboko MA, Owusu-Agyei S, Phyo AP, Premji Z, Price RN, Pukrittayakamee S, Ramharter M, Sagara I, Se Y, Suon S, Stepniewska K, Ward SA, White NJ, and Winstanley PA
- Subjects
- Adolescent, Adult, Aged, Animals, Child, Child, Preschool, Clinical Trials as Topic, Drug Resistance, Female, Humans, Infant, Male, Middle Aged, Plasmodium falciparum drug effects, Young Adult, Antimalarials administration & dosage, Artemisinins administration & dosage, Blood parasitology, Malaria, Falciparum drug therapy, Parasitemia drug therapy, Plasmodium falciparum isolation & purification
- Abstract
Background: Artemisinin resistance in Plasmodium falciparum manifests as slow parasite clearance but this measure is also influenced by host immunity, initial parasite biomass and partner drug efficacy. This study collated data from clinical trials of artemisinin derivatives in falciparum malaria with frequent parasite counts to provide reference parasite clearance estimates stratified by location, treatment and time, to examine host factors affecting parasite clearance, and to assess the relationships between parasite clearance and risk of recrudescence during follow-up., Methods: Data from 24 studies, conducted from 1996 to 2013, with frequent parasite counts were pooled. Parasite clearance half-life (PC1/2) was estimated using the WWARN Parasite Clearance Estimator. Random effects regression models accounting for study and site heterogeneity were used to explore factors affecting PC1/2 and risk of recrudescence within areas with reported delayed parasite clearance (western Cambodia, western Thailand after 2000, southern Vietnam, southern Myanmar) and in all other areas where parasite populations are artemisinin sensitive., Results: PC1/2 was estimated in 6975 patients, 3288 of whom also had treatment outcomes evaluate d during 28-63 days follow-up, with 93 (2.8 %) PCR-confirmed recrudescences. In areas with artemisinin-sensitive parasites, the median PC1/2 following three-day artesunate treatment (4 mg/kg/day) ranged from 1.8 to 3.0 h and the proportion of patients with PC1/2 >5 h from 0 to 10 %. Artesunate doses of 4 mg/kg/day decreased PC1/2 by 8.1 % (95 % CI 3.2-12.6) compared to 2 mg/kg/day, except in populations with delayed parasite clearance. PC1/2 was longer in children and in patients with fever or anaemia at enrolment. Long PC1/2 (HR = 2.91, 95 % CI 1.95-4.34 for twofold increase, p < 0.001) and high initial parasitaemia (HR = 2.23, 95 % CI 1.44-3.45 for tenfold increase, p < 0.001) were associated independently with an increased risk of recrudescence. In western Cambodia, the region with the highest prevalence of artemisinin resistance, there was no evidence for increasing PC1/2 since 2007., Conclusions: Several factors affect PC1/2. As substantial heterogeneity in parasite clearance exists between locations, early detection of artemisinin resistance requires reference PC1/2 data. Studies with frequent parasite count measurements to characterize PC1/2 should be encouraged. In western Cambodia, where PC1/2 values are longest, there is no evidence for recent emergence of higher levels of artemisinin resistance.
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- 2015
- Full Text
- View/download PDF
22. The effect of dosing strategies on the therapeutic efficacy of artesunate-amodiaquine for uncomplicated malaria: a meta-analysis of individual patient data.
- Author
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Adjuik MA, Allan R, Anvikar AR, Ashley EA, Ba MS, Barennes H, Barnes KI, Bassat Q, Baudin E, Björkman A, Bompart F, Bonnet M, Borrmann S, Brasseur P, Bukirwa H, Checchi F, Cot M, Dahal P, D'Alessandro U, Deloron P, Desai M, Diap G, Djimde AA, Dorsey G, Doumbo OK, Espié E, Etard JF, Fanello CI, Faucher JF, Faye B, Flegg JA, Gaye O, Gething PW, González R, Grandesso F, Guerin PJ, Guthmann JP, Hamour S, Hasugian AR, Hay SI, Humphreys GS, Jullien V, Juma E, Kamya MR, Karema C, Kiechel JR, Kremsner PG, Krishna S, Lameyre V, Ibrahim LM, Lee SJ, Lell B, Mårtensson A, Massougbodji A, Menan H, Ménard D, Menéndez C, Meremikwu M, Moreira C, Nabasumba C, Nambozi M, Ndiaye JL, Nikiema F, Nsanzabana C, Ntoumi F, Ogutu BR, Olliaro P, Osorio L, Ouédraogo JB, Penali LK, Pene M, Pinoges L, Piola P, Price RN, Roper C, Rosenthal PJ, Rwagacondo CE, Same-Ekobo A, Schramm B, Seck A, Sharma B, Sibley CH, Sinou V, Sirima SB, Smith JJ, Smithuis F, Somé FA, Sow D, Staedke SG, Stepniewska K, Swarthout TD, Sylla K, Talisuna AO, Tarning J, Taylor WR, Temu EA, Thwing JI, Tjitra E, Tine RC, Tinto H, Vaillant MT, Valecha N, Van den Broek I, White NJ, Yeka A, and Zongo I
- Subjects
- Africa, Dose-Response Relationship, Drug, Drug Combinations, Female, Humans, Male, Middle Aged, Recurrence, Risk Factors, Treatment Outcome, Amodiaquine administration & dosage, Antimalarials administration & dosage, Artemisinins administration & dosage, Malaria, Falciparum drug therapy
- Abstract
Background: Artesunate-amodiaquine (AS-AQ) is one of the most widely used artemisinin-based combination therapies (ACTs) to treat uncomplicated Plasmodium falciparum malaria in Africa. We investigated the impact of different dosing strategies on the efficacy of this combination for the treatment of falciparum malaria., Methods: Individual patient data from AS-AQ clinical trials were pooled using the WorldWide Antimalarial Resistance Network (WWARN) standardised methodology. Risk factors for treatment failure were identified using a Cox regression model with shared frailty across study sites., Results: Forty-three studies representing 9,106 treatments from 1999-2012 were included in the analysis; 4,138 (45.4%) treatments were with a fixed dose combination with an AQ target dose of 30 mg/kg (FDC), 1,293 (14.2%) with a non-fixed dose combination with an AQ target dose of 25 mg/kg (loose NFDC-25), 2,418 (26.6%) with a non-fixed dose combination with an AQ target dose of 30 mg/kg (loose NFDC-30), and the remaining 1,257 (13.8%) with a co-blistered non-fixed dose combination with an AQ target dose of 30 mg/kg (co-blistered NFDC). The median dose of AQ administered was 32.1 mg/kg [IQR: 25.9-38.2], the highest dose being administered to patients treated with co-blistered NFDC (median = 35.3 mg/kg [IQR: 30.6-43.7]) and the lowest to those treated with loose NFDC-25 (median = 25.0 mg/kg [IQR: 22.7-25.0]). Patients treated with FDC received a median dose of 32.4 mg/kg [IQR: 27-39.0]. After adjusting for reinfections, the corrected antimalarial efficacy on day 28 after treatment was similar for co-blistered NFDC (97.9% [95% confidence interval (CI): 97.0-98.8%]) and FDC (98.1% [95% CI: 97.6%-98.5%]; P = 0.799), but significantly lower for the loose NFDC-25 (93.4% [95% CI: 91.9%-94.9%]), and loose NFDC-30 (95.0% [95% CI: 94.1%-95.9%]) (P < 0.001 for all comparisons). After controlling for age, AQ dose, baseline parasitemia and region; treatment with loose NFDC-25 was associated with a 3.5-fold greater risk of recrudescence by day 28 (adjusted hazard ratio, AHR = 3.51 [95% CI: 2.02-6.12], P < 0.001) compared to FDC, and treatment with loose NFDC-30 was associated with a higher risk of recrudescence at only three sites., Conclusions: There was substantial variation in the total dose of amodiaquine administered in different AS-AQ combination regimens. Fixed dose AS-AQ combinations ensure optimal dosing and provide higher antimalarial treatment efficacy than the loose individual tablets in all age categories.
- Published
- 2015
- Full Text
- View/download PDF
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