The perils of PCR: can we accurately ‘correct’ antimalarial trials?

During follow-up in antimalarial drug trials, treated subjects can be newly infected. PCR correction is used to distinguish this re-infection from drug failure (recrudescence) and to adjust final drug efficacy estimates. The epidemiological, biological and technical limitations of PCR correction and...

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Bibliographic Details
Published inTrends in parasitology Vol. 26; no. 3; pp. 119 - 124
Main Authors Juliano, Jonathan J., Gadalla, Nahla, Sutherland, Colin J., Meshnick, Steven R.
Format Journal Article
LanguageEnglish
Published Amsterdam Elsevier Ltd 01.03.2010
Elsevier
Subjects
Animal aquaculture
Animal productions
Antimalarials - therapeutic use
Biological and medical sciences
Clinical Trials as Topic - methods
Crustacea
Drugs
Fundamental and applied biological sciences. Psychology
Gastroenterology and Hepatology
Humans
Infectious Disease
Invertebrate aquaculture
Malaria - drug therapy
Polymerase Chain Reaction - methods
Polymerase chain reaction
Parasite
Antimalarial
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Summary:During follow-up in antimalarial drug trials, treated subjects can be newly infected. PCR correction is used to distinguish this re-infection from drug failure (recrudescence) and to adjust final drug efficacy estimates. The epidemiological, biological and technical limitations of PCR correction and how this can lead to misclassification in drug trial outcomes are underappreciated. This article considers these limitations and proposes a framework for reporting, interpreting and improving PCR correction of antimalarial trials.
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ISSN:1471-4922
1471-5007
1471-5007
DOI:10.1016/j.pt.2009.12.007