{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:46:12Z","timestamp":1760150772101,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>The combinations of artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) are used as first-line treatments for uncomplicated malaria in the Ivory Coast. Different studies document the efficacy of two artemisinin-based combination therapies (ACTs) (AL and ASAQ) in the Ivory Coast. However, there is no meta-analysis examining the data set of these studies. The purpose of this work was to determine the prevalence of malaria treatment failure cases in randomized control trials with two artemisinin-based combination therapies (AL versus ASAQ) in the Ivory Coast between 2009 to 2016. This study is a meta-analysis of data from the results of four previous multicenter, open-label, randomized clinical trial studies evaluating the clinical and parasitological efficacy of artemether-lumefantrine and artesunate-amodiaquine conducted between 2009 and 2016 following World Health Organization (WHO) protocol at sentinel sites in the Ivory Coast. These drug efficacy data collected between 2009 and 2016 were analyzed. During these studies, to distinguish between recrudescence and new infection, molecular genotyping of genes encoding merozoite surface protein 1 and 2 was carried out using nested polymerase chain reaction (PCR). A total of 1575 patients enrolled in the four studies, including 768 in the AL arm and 762 in the ASAQ arm, which were fully followed either for 28 days or 42 days according to WHO protocol. The adequate clinical and parasitological response (ACPR) was higher than 95% in the two groups (intention to treat (ITT): AL = 96.59% and ASAQ = 96.81; Per Protocol (PP): AL = 99.48% and ASAQ = 99.61%) after PCR correction at day 28. Aggregate data analysis (2009\u20132016) showed that at day 28, the proportions of patients with recurrent infection was higher in the AL group (ITT: 3.79%, PP: 3.9%) than in the ASAQ group (ITT: 2.17%, PP: 2.23%). After PCR correction, most treatment failures were classified as new infections (AL group (ITT: 0.13%, PP: 0.13%); ASAQ group (ITT: 0.39%, PP: 0.39%). The recrudescent infections rate was high, at 0.39% compared to 0.13% for ASAQ and AL, respectively, for both ITT and PP, no significant difference. However, the Kaplan\u2013Meier curve of cumulative treatment success showed a significant difference between the two groups after PCR from 2012\u20132013 (p = 0.032). Overall, ASAQ and AL have been shown to be effective drugs for the treatment of uncomplicated P. falciparum malaria in the study areas, 14 years after deployment of these drugs.<\/jats:p>","DOI":"10.3390\/tropicalmed9010010","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T06:18:13Z","timestamp":1703830693000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Meta-Analysis of Data from Four Clinical Trials in the Ivory Coast Assessing the Efficacy of Two Artemisinin-Based Combination Therapies (Artesunate-Amodiaquine and Artemether-Lumefantrine) between 2009 and 2016"],"prefix":"10.3390","volume":"9","author":[{"given":"Akoua Val\u00e9rie","family":"B\u00e9dia-Tanoh","sequence":"first","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"},{"name":"Malaria Research and Control Center\/National Institute of Public Health, Abidjan P.O. Box V47, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kondo Fulgence","family":"Kassi","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"},{"name":"Diagnostic and Research Center on AIDS and Others Infectious Diseases (CeDReS), University Hospital Center, Treichville, Abidjan P.O. Box V13, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Offianan Andr\u00e9","family":"Tour\u00e9","sequence":"additional","affiliation":[{"name":"Malariology Department Institut Pasteur of Ivory Coast, Abidjan P.O. Box 490, C\u00f4te d\u2019Ivoire"},{"name":"Scientific Advisory Board of National Malaria Control Program, Abidjan P.O. Box V4, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge Brice","family":"Assi","sequence":"additional","affiliation":[{"name":"Scientific Advisory Board of National Malaria Control Program, Abidjan P.O. Box V4, C\u00f4te d\u2019Ivoire"},{"name":"Pierre Richet Institute (IPR) Bouake\/National Institute of Public Health, Bouak\u00e9 P.O. Box 1500, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akpa Paterne","family":"Gnagne","sequence":"additional","affiliation":[{"name":"Malaria Research and Control Center\/National Institute of Public Health, Abidjan P.O. Box V47, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koffi Daho","family":"Adoubryn","sequence":"additional","affiliation":[{"name":"Scientific Advisory Board of National Malaria Control Program, Abidjan P.O. Box V4, C\u00f4te d\u2019Ivoire"},{"name":"Parasitology and Mycology Department, Training and Research Unit of Medical Sciences, University Alassane Ouattara, Bouak\u00e9 P.O. Box 1801, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Bissagnene","sequence":"additional","affiliation":[{"name":"Scientific Advisory Board of National Malaria Control Program, Abidjan P.O. Box V4, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abibatou","family":"Konat\u00e9","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Sebastien","family":"Miezan","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7589-9175","authenticated-orcid":false,"given":"Kpongbo Etienne","family":"Angora","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henriette","family":"Vanga-Bosson","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"},{"name":"Malariology Department Institut Pasteur of Ivory Coast, Abidjan P.O. Box 490, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pulch\u00e9rie Christiane","family":"Kiki-Barro","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Djohan","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"},{"name":"Pierre Richet Institute (IPR) Bouake\/National Institute of Public Health, Bouak\u00e9 P.O. Box 1500, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2711-5073","authenticated-orcid":false,"given":"William","family":"Yavo","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"},{"name":"Malaria Research and Control Center\/National Institute of Public Health, Abidjan P.O. Box V47, C\u00f4te d\u2019Ivoire"},{"name":"Scientific Advisory Board of National Malaria Control Program, Abidjan P.O. Box V4, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eby Ignace","family":"Herv\u00e9 Menan","sequence":"additional","affiliation":[{"name":"Parasitology and Mycology Departement, Training and Research Unit of Pharmaceutical and Biological Sciences, University F\u00e9lix Houphou\u00ebt-Boigny, Abidjan P.O. Box V34, C\u00f4te d\u2019Ivoire"},{"name":"Scientific Advisory Board of National Malaria Control Program, Abidjan P.O. Box V4, C\u00f4te d\u2019Ivoire"},{"name":"Pierre Richet Institute (IPR) Bouake\/National Institute of Public Health, Bouak\u00e9 P.O. Box 1500, C\u00f4te d\u2019Ivoire"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"ref_1","unstructured":"WHO (2022). WHO World Malaria Report 2022, WHO."},{"key":"ref_2","unstructured":"WHO (2021). 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Health"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/1\/10\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:44:03Z","timestamp":1760132643000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/1\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,29]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["tropicalmed9010010"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed9010010","relation":{},"ISSN":["2414-6366"],"issn-type":[{"type":"electronic","value":"2414-6366"}],"subject":[],"published":{"date-parts":[[2023,12,29]]}}}