Declining responsiveness of childhood Plasmodium falciparum infections to artemisinin-based combination treatments ten years following deployment as first-line antimalarials in Nigeria

Table 2 Therapeutic responses in malarious children following artemisinin-based combination chemotherapies

Variables	All treatments			P value	Artemether-lumefantrine		P value	Artesunate-amodiaquine		P value
Variables	2009–2010 (n = 743)	2014–2015 (n = 598)	All (n = 1341)	P value	2009–2010 (n = 360)	2014–2015 (n = 303)	P value	2009–2010 (n = 384)	2014–2015 (n = 295)	P value
Clinical response
FCT (day)
Mean	1.1	1.2	1.2	0.002	1.1	1.3	0.002	1.1	1.1	0.36
95% CI	1.08–1.14	1.2–1.3	1.1–1.2		1.1–1.2	1.2–1.4		1.05–1.12	1.1–1.2
Parasitological responses
APPD1 (%)	398 (53.6)	370 (61.9)	768 (57.3)	0.002	210 (58.3)	199 (65.7)	0.06	188 (49.1)	171 (58)	0.02
APPD2 (%)	38 (5.1)	153 (25.6)	191 (14.2)	< 0.0001	21 (5.8)	83 (27.4)	< 0.0001	17 (4.4)	70 (23.7)	< 0.0001
APPD3 (%)	7 (0.9)	14 (2.3)	21 (1.6)	0.07	2 (0.6)	9 (3)	0.03	5 (1.3)	5 (1.7)	0.92
PRRD1
Geometric mean	444	409	428	0.75	318	270	0.63	609	627	0.86
95% CI	349–565	315–531	359–511		222–454	186–391		440–841	438–898
PRRD2
Geometric mean	7594	11136	4723	< 0.0001	11112	4439	0.0002	11 158	5034	0.007
95% CI	6709–8597	9742–12729	3802–5868		9092–13 581	3276–6016		9335–13 337	3691–6864
PCT (day)
Mean	1.6	1.9	1.8	< 0.0001	1.7	2	< 0.0001	1.6	1.9	< 0.0001
95% CI	1.55–1.64	1.9–2.0	1.7–1.8		1.6–1.7	1.9–2.1		1.5–1.6	1.8–2.0
Haematological response
AnRT (day)
Mean	10.6	10.1	10.4	0.53	11.1	11	0.9	10	9.2	0.4
95% CI	9.7–11.5	9.0–11.2	9.7–11.1		9.8–12.5	9.3–12.8		8.8–11.3	7.8–10.7

FCT Fever clearance time, APPD1: Asexual parasite positivity 1 day post-treatment initiation, APPD2 Asexual parasite positivity 2 days post-treatment initiation, APPD3 Asexual parasite positivity 3 days post-treatment initiation, PRRD1 Parasite reduction ratio 1 day post-treatment initiation, PRRD2 Parasite reduction ratio 2 days post-treatment initiation, PCT Parasite clearance time, AnRT Anaemia recovery time

ISSN: 2049-9957