Prospective evaluation of artemether-lumefantrine for the treatment of non-falciparum and mixed-species malaria in Gabon

Malar J. 2012 Jul 10;11:120. doi: 10.1186/1475-2875-11-120.

Abstract

Background: The recommendation of artemisinin combination therapy (ACT) as first-line treatment for uncomplicated falciparum malaria is supported by a plethora of high quality clinical trials. However, their recommendation for the treatment of mixed-species malaria and the large-scale use for the treatment of non-falciparum malaria in endemic regions is based on anecdotal rather than systematic clinical evidence.

Methods: This study prospectively observed the efficacy of artemether-lumefantrine for the treatment of uncomplicated non-falciparum or mixed-species malaria in two routine district hospitals in the Central African country of Gabon.

Results: Forty patients suffering from uncomplicated Plasmodium malariae, Plasmodium ovale or mixed-species malaria (including Plasmodium falciparum) presenting at the hospital received artemether-lumefantrine treatment and were followed up. All evaluable patients (n=38) showed an adequate clinical and parasitological response on Day 28 after oral treatment with artemether-lumefantrine (95% confidence interval: 0.91,1). All adverse events were of mild to moderate intensity and completely resolved by the end of study.

Conclusions: This first systematic assessment of artemether-lumefantrine treatment for P. malariae, P. ovale and mixed-species malaria demonstrated a high cure rate of 100% and a favourable tolerability profile, and thus lends support to the practice of treating non-falciparum or mixed-species malaria, or all cases of malaria without definite species differentiation, with artemether-lumefantrine in Gabon.

Trial registration: ClinicalTrials.gov Identifier: NCT00725777.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Antimalarials / administration & dosage*
  • Antimalarials / adverse effects
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins / administration & dosage*
  • Artemisinins / adverse effects
  • Child
  • Child, Preschool
  • Coinfection / drug therapy*
  • Coinfection / parasitology
  • Drug Combinations
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Ethanolamines / administration & dosage*
  • Ethanolamines / adverse effects
  • Female
  • Fluorenes / administration & dosage*
  • Fluorenes / adverse effects
  • Gabon
  • Humans
  • Malaria / drug therapy*
  • Malaria / parasitology
  • Male
  • Middle Aged
  • Plasmodium falciparum / isolation & purification
  • Plasmodium malariae / isolation & purification
  • Plasmodium ovale / isolation & purification
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Antimalarials
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins
  • Drug Combinations
  • Ethanolamines
  • Fluorenes

Associated data

  • ClinicalTrials.gov/NCT00725777