{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:20:18Z","timestamp":1779909618193,"version":"3.53.1"},"reference-count":56,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2_Suppl","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    The efficacy of artesunate + amodiaquine (ASAQ) and artemether + lumefantrine (AL) for treating malaria was investigated in Madagascar in 2020. A randomized parallel-group study was conducted at four health centers (Antsenavolo, Vohitromby, and Matanga in the southeastern region and Ankazomborona in the northwestern region). The therapeutic efficacy and safety of ASAQ and AL were assessed using the WHO protocol, with a 28-day follow-up period. Children aged 6 months to 14 years with uncomplicated\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    (\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    ) malaria were randomly assigned to receive either ASAQ or AL. Genotyping assays for the\n                    <jats:italic>pfK13<\/jats:italic>\n                    gene were conducted on\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    isolates obtained from dry blood samples collected on Day 0. Of 765 enrolled patients, 709 (92.7%) reached the study endpoint. Among the per-protocol population, crude adequate clinical and parasitological response (ACPR) rates were 99%, 99%, 100%, and 100% for Antsenavolo, Vohitromby, Matanga, and Ankazomborona, respectively, in the ASAQ group and 98%, 91%, 90%, and 100% for the same locations, respectively, in the AL group. Polymerase chain reaction-corrected ACPR rates were 100% for the ASAQ group at all study sites, whereas for the AL group, they were 98.8% in Antsenavolo, 97.6% in Vohitromby, 100% in Matanga, and 100% in Ankazomborona. Day 3 slide positivity rates were 0%, 1%, 1%, and 0% for Antsenavolo, Vohitromby, Matanga, and Ankazomborona, respectively. During follow-up, mild and moderate adverse events, including gastrointestinal issues (abdominal pain and vomiting) and headache, were reported in 10.2% (72\/709) of patients. Of 727 samples successfully analyzed for\n                    <jats:italic>pfK13<\/jats:italic>\n                    , no mutation associated with artemisinin resistance was observed. The study results reveal that ASAQ and AL remain safe and efficacious for treating uncomplicated\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    malaria in Madagascar.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.24-0844","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T17:44:32Z","timestamp":1762278272000},"page":"14-22","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Artesunate + Amodiaquine and Artemether + Lumefantrine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Madagascar, 2020"],"prefix":"10.4269","volume":"114","author":[{"given":"Aina","family":"Harimanana","sequence":"first","affiliation":[{"name":"Institut Pasteur de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina Ny Aina Liantsoa","family":"Randriamiarinjatovo","sequence":"additional","affiliation":[{"name":"Institut Pasteur de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tovonanahary Angelo","family":"Rakotomanga","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre le Paludisme, Minist\u00e8re de la Sant\u00e9 Publique de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judickaelle","family":"Irinantenaina","sequence":"additional","affiliation":[{"name":"Institut Pasteur de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah F.","family":"Moriarty","sequence":"additional","affiliation":[{"name":"US President\u2019s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Laird","sequence":"additional","affiliation":[{"name":"US President\u2019s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruviben","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rispah A.","family":"Abdallah","sequence":"additional","affiliation":[{"name":"US President\u2019s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Zhiyong","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaly Souza","family":"Svigel","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Kapesa","sequence":"additional","affiliation":[{"name":"US President\u2019s Malaria Initiative, US Agency for International Development, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Razafindrakoto","sequence":"additional","affiliation":[{"name":"US President\u2019s Malaria Initiative, US Agency for International Development, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanomezantsoa","family":"Ralinoro","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre le Paludisme, Minist\u00e8re de la Sant\u00e9 Publique de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Ange","family":"Rason","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre le Paludisme, Minist\u00e8re de la Sant\u00e9 Publique de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricette Nambinisoa","family":"Andriamananjara","sequence":"additional","affiliation":[{"name":"PMI EVOLVE Project, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seheno","family":"Razanatsiorimalala","sequence":"additional","affiliation":[{"name":"Institut Pasteur de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celestin","family":"Razafinjato","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre le Paludisme, Minist\u00e8re de la Sant\u00e9 Publique de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milijaona","family":"Randrianarivelojosia","sequence":"additional","affiliation":[{"name":"Institut Pasteur de Madagascar, Antananarivo, Madagascar;"},{"name":"Universit\u00e9 de Toliara, Toliara, Madagascar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Trans R Soc Trop Med Hyg","first-page":"3","article-title":"Lessons learnt from the six decades of chloroquine use (1945\u20132005) to control malaria in Madagascar","volume":"103","author":"Randrianarivelojosia","year":"2009"},{"key":"b2","series-title":"Malar J","first-page":"125","article-title":"Randomized, multicentre 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