Cited by 38Malaria Research and ControlPhytochemical compounds biological activitiesEthnobotanical and Medicinal Plants Studies

RETRACTED: Artemisia annua and Artemisia afra tea infusions vs. artesunate-amodiaquine (ASAQ) in treating Plasmodium falciparum malaria in a large scale, double blind, randomized clinical trial

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Munyangi, Jérôme, Cornet-Vernet, Lucile, Idumbo, Michel, Lu, Chen, Lutgen, Pierre, Perronne, Christian, Ngombe, Nadège, Bianga, Jacques +6 more·2019·Phytomedicine

Abstract

Background and objective Prior small-scale clinical trials showed that Artemisia annua and Artemisia afra infusions, decoctions, capsules, or tablets were low cost, easy to use, and efficient in curing malaria infections. In a larger-scale trial in Kalima district, Democratic Republic of Congo, we aimed to show A. annua and/or A. afra infusions were superior or at least equivalent to artesunate-amodiaquine (ASAQ) against malaria.Methods A double blind, randomized clinical trial with 957 malaria-infected patients had two treatment arms: 472 patients for ASAQ and 471 for Artemisia (248 A. annua, 223 A. afra) remained at end of the trial. ASAQ-treated patients were treated per manufacturer posology, and Artemisia-treated patients received 1 l/d of dry leaf/twig infusions for 7 d; both arms had 28 d follow-up. Parasitemia and gametocytes were measured microscopically with results statistically compared among arms for age and gender.Results Artemisinin content of A. afra was negligible, but therapeutic responses of patients were similar to A. annua-treated patients; trophozoites cleared after 24 h, but took up to 14 d to clear in ASAQ-treated patients. D28 cure rates defined as absence of parasitemia were for pediatrics 82, 91, and 50% for A. afra, A. annua and ASAQ; while for adults cure rates were 91, 100, and 30%, respectively. Fever clearance took 48 h for ASAQ, but 24 h for Artemisia. From D14-28 no Artemisia-treated patients had microscopically detectable gametocytes, while 10 ASAQ-treated patients remained gametocyte carriers at D28. More females than males were gametocyte carriers in the ASAQ arm but were unaffected in the Artemisia arms. Hemoglobin remained constant at 11 g/dl for A. afra after D1, while for A. annua and ASAQ it decreased to 9-9.5 g/dl. Only 5.0% of Artemisia-treated patients reported adverse effects, vs. 42.8% for ASAQ.Conclusion A. annua and A. afra infusions are polytherapies with better outcomes than ASAQ against malaria. In contrast to ASAQ, both Artemisias appeared to break the cycle of malaria by eliminating gametocytes. This study merits further investigation for possible inclusion of Artemisia tea infusions as an alternative for fighting and eradicating malaria.

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Crossref · 10.1016/j.phymed.2018.12.002This paper is marked retracted.

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  • Dry leaf consumption of A. annua is showing efficacy in human trials.

    “Another reason for increasing the in planta artemisinin content is that dry leaf consumption of A. annua is showing efficacy in human trials (Daddy et al. 2017; Munyangi et al. 2019) and seems resilient against the evolution of artemisinin drug resistance as maybe shown in humans (Daddy et al. 2017) and in Plasmodium yoelii -infected mice (Elfawal et al. 2015).”

    From Enhancing artemisinin content in and delivery from Artemisia annua: a review of alternative, classical, and transgenic approaches (2021) · cites this paper as Munyangi et al. 2019

    The Methods (Drug administration; page unavailable) say patients drank a filtered infusion made from dried A. annua leaves and twigs, not the dry leaves themselves. The Results (Fever and parasitemia progression; page unavailable) report a 96.4% day-28 cure rate for A. annua-treated patients. The trial therefore supports reported efficacy of a dried-leaf infusion in humans, but not efficacy of dry-leaf consumption as stated. (LLM, conf=0.88)

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  • Given that many diseases have responded to treatments using A. annua tea infusions or other forms of directly using the plant, obtaining ever increasing levels of artemisinin may not be as critically needed as previously considered.

    “Given that many of the diseases, e.g. malaria, schistosomiasis, leishmania etc., that have responded to treatments using A. annua tea infusions (Munyangi et al. 2018, 2019) or other forms of directly using the plant, e.g. encapsulated powdered leaves (Onimus et al. 2013; Mesa et al. 2017) or compressed leaf tablets (Daddy et al. 2017), obtaining ever increasing levels of artemisinin may not be as”
  • A recent positive clinical test in humans suggested A. annua is quite effective at eliminating various stages of the malaria parasite including gametocytes, which has been verified in vitro.

    “Traditionally A. annua was used as tea infusion and a recent positive clinical test in humans (Munyangi et al. 2019) suggested the plant is quite effective at eliminating various stages of the malaria parasite including gametocytes, which has been now verified in vitro (Snider and Weathers 2021).”

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Cites

1 retracted

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Research works printed but not linked: 3

  1. Chang HM, But PPH, 1986 Pharmacology and Applications of Chinese Materia Media Volume 1 World Scientific Publishing, Singapore.
  2. Chougouo-Kengne RD, Kouamouo J, Mouyou-Somo R, Penge On’ Okoko A, 2012 Etude comparative de l’efficacité thérapeutique de l’Artesunate seul ou en association avec l’amodiaquine et de la tisane de Artemisia annua cultive à l’ouest du Cameroun. Annales de Pharmacie de l’Université de Kinshasa (RDC) 4 (1), 129– 150.
  3. Zhang JF, 2005 A Detailed Chronological Record of Project 523 and the Discovery and Development of Qinghaosu (Artemisinin) Vol. 193 Yangcheng Evening News Publishing Company, China.

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Authors
Munyangi, J., Cornet-Vernet, L., Idumbo, M., Lu, C., Lutgen, P., Perronne, C., Ngombe, N., Bianga, J., Mupenda, B., Lalukala, P., Mergeai, G., Mumba, D., Towler, M., & Weathers, P.
Affiliations
  • University of Kolwezi (CD)
  • Worcester Polytechnic Institute (US)
  • University of Kinshasa (CD)
  • Ministry of Public Health (CD)
  • University of Liège (BE)
Corresponding author
Cornet-Vernet, Lucile
Venue
Phytomedicine
Publisher
Elsevier BV
Published
2019-04
Volume
57
Pages
49-56
ISSN
0944-7113 (ISSN-L)
OpenAlex
W2903069521
Cited by
38
References
27
Citations by year
2025: 2 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 11 · 2019: 10
FWCI
5.95
Type
journal article
Language
en
Status
Retracted
Open access
Locations
  • Phytomedicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • ORBi (University of Liège) (acceptedVersion)
Funders
National Center for Complementary and Integrative Health (Award Number 2NIH-R15AT008277-02)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Phytochemical compounds biological activities
  • Life Sciences › Agricultural and Biological Sciences › Plant Science › Ethnobotanical and Medicinal Plants Studies
Keywords
Artemisia annua, Artemisia afra, artesunate-amodiaquine, falciparum malaria, gametocyte clearance, fever clearance, adverse effects, hemoglobin, retracted article, Democratic Republic of the Congo
MeSH terms
Adolescent, Adult, Amodiaquine, Antimalarials, Child, Double-Blind Method, Drug Combinations, Female, Fever, Hemoglobins, Humans, Male, Middle Aged, Plants, Medicinal, Malaria, Falciparum, Treatment Outcome, Parasitemia, Artemisia, Plant Preparations, Artemisia annua, Artemisinins

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