University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne School of Population and Global Health
  • Melbourne School of Population and Global Health - Research Publications
  • View Item
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne School of Population and Global Health
  • Melbourne School of Population and Global Health - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    Immunity as a predictor of anti-malarial treatment failure: a systematic review

    Thumbnail
    Download
    Published version (1.066Mb)

    Citations
    Scopus
    Altmetric
    5
    Author
    O'Flaherty, K; Maguire, J; Simpson, JA; Fowkes, FJI
    Date
    2017-04-20
    Source Title
    Malaria Journal
    Publisher
    BMC
    University of Melbourne Author/s
    Simpson, Julie; Fowkes, Freya; O'Flaherty, Katherine
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    O'Flaherty, K., Maguire, J., Simpson, J. A. & Fowkes, F. J. I. (2017). Immunity as a predictor of anti-malarial treatment failure: a systematic review. MALARIA JOURNAL, 16 (1), https://doi.org/10.1186/s12936-017-1815-y.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/259133
    DOI
    10.1186/s12936-017-1815-y
    Abstract
    BACKGROUND: Naturally acquired immunity can reduce parasitaemia and potentially influence anti-malarial treatment outcomes; however, evidence for this in the current literature provides conflicted results. The available evidence was synthesized to determine and quantify the association between host immunity and anti-malarial treatment failure. METHODS: Four databases were searched to identify studies investigating malaria antibody levels in patients receiving anti-malarial treatment for symptomatic malaria with treatment failure recorded according to the World Health Organization classification. Odds ratios or hazard ratios were extracted or calculated to quantify the association between malarial antibody levels and treatment failure, and findings from different studies were visualized using forest plots. RESULTS: Eight studies, including patients with falciparum malaria treated with mono- and combination therapy of artemisinin derivatives, sulfadoxine, pyrimethamine and chloroquine, were identified. Reported and calculated effect estimates varied greatly between studies, even those assessing the same antigens and treatments. An association between blood-stage IgG responses and treatment efficacy was observed. The greatest magnitudes of effect were observed for artemisinin [OR/HR (95% CI) range 0.02 (0.00, 0.45)-1.08 (0.57, 2.06)] and chloroquine [0.24 (0.04, 1.37)-0.32 (0.05, 1.96)] treatments, and larger magnitudes of effect were observed for variant surface antigen responses [0.02 (0.00, 0.45)-1.92 (0.94, 3.91)] when compared with merozoite specific responses [0.24 (0.04, 1.37)-2.83 (1.13, 7.09)]. CONCLUSIONS: Naturally acquired malarial immunity is associated with reduced anti-malarial treatment failure in malaria endemic populations. Anti-malarial IgG effects treatment outcome differently for different anti-malarial drugs and antigen targets, and had the greatest impact during treatment with the current first-line treatments, the artemisinins. This has implications for the assessment of the therapeutic efficacy of anti-malarials, particularly in the context of emerging artemisinin resistance.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [52609]
    • Melbourne School of Population and Global Health - Research Publications [5315]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors