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We demonstrate that patients infected with Salmonella serotype Typhi isolates with DCS show evidence of a longer time to fever clearance and more frequent treatment failure.
Additional goals, such as improving time to fever resolution, reduction in hospital admission rate, and reduction in mortality, while also ultimately desirable, were not assessed in this study.
A prospective trial will need to be carried out both to corroborate these findings as well as to investigate the ability of the protocol to influence additional outcome measures such as time to fever resolution, hospital admission rate, and mortality rate.
Median time to fever clearance was 15.9 h (95%CI 15.7, 16.0) with pyronaridine-artesunate and 23.8 h (95%CI 16.0, 24.0) with chloroquine.
However Kaplan-Meier analysis of the ITT population showed a shorter time to fever clearance with pyronaridine-artesunate than with chloroquine (p = 0.0017; Figure 4).
Secondary endpoints included day 14 and 42 ACPR rates, time to fever resolution (axillary temperature≤37.5°C), time to parasite clearance, change in haemoglobin from day 0 to day 14 and the appearance of gametocytes by day 28 after treatment.
Similar(42)
The proportion of all patients failing through time to clear fever is shown in Figure 2. At day 7 fever clearance rate was 73.9% (67.0% – 80.3 %) in cefixime group and 94.2% 90.2%% – 96.9%) in gatifloxacin group.
It is time to break the fever.
Time to resolution of fever, other symptoms and clinical signs.
These studies also recorded time to parasite and fever clearance, as defined below (see Data analysis).
Time-to-event analyses, including time to parasite and fever clearance and the efficacy of the consolidated treatment in suppressing parasitaemia post treatment (reappearance of parasites), were represented using crude Kaplan-Meier plots (these are provided as graphs only where the difference in estimates was significant).
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