Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia
Abstract Background In 2004, Ethiopia adopted artemether-lumefantrine (AL, Coartem®) as first-line treatment for the management of uncomplicated Plasmodium falciparum malaria. Continuous monitoring of AL therapeutic efficacy is crucial in Ethiopia, as per the World Health Organization (WHO) recommen...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12936-022-04436-8 |
| _version_ | 1797958842236010496 |
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| author | Kale Gubae Hussein Mohammed Heven Sime Henok Hailgiorgis Anteneh Kassahun Mare Bokretsion Gidey Mebrahtom Haile Gudissa Assefa Worku Bekele Geremew Tasew Solomon Mequanente Abay Ashenafi Assefa |
| author_facet | Kale Gubae Hussein Mohammed Heven Sime Henok Hailgiorgis Anteneh Kassahun Mare Bokretsion Gidey Mebrahtom Haile Gudissa Assefa Worku Bekele Geremew Tasew Solomon Mequanente Abay Ashenafi Assefa |
| author_sort | Kale Gubae |
| collection | DOAJ |
| description | Abstract Background In 2004, Ethiopia adopted artemether-lumefantrine (AL, Coartem®) as first-line treatment for the management of uncomplicated Plasmodium falciparum malaria. Continuous monitoring of AL therapeutic efficacy is crucial in Ethiopia, as per the World Health Organization (WHO) recommendation. This study aimed to assess the therapeutic efficacy of AL in the treatment of uncomplicated P. falciparum infection. Methods A 28 day onearm, prospective evaluation of the clinical and parasitological response to AL was conducted at Shecha Health Centre, Arba Minch town, Southern Ethiopia. Patients were treated with six-dose regimen of AL over three days and monitored for 28 days with clinical and laboratory assessments. Participant recruitment and outcome classification was done in accordance with the 2009 WHO methods for surveillance of anti-malarial drug efficacy guidelines. Results A total of 88 study participants were enrolled and 69 of them completed the study with adequate clinical and parasitological response. Two late parasitological failures were observed, of which one was classified as a recrudescence by polymerase chain reaction (PCR). The PCRcorrected cure rate was 98.6% (95% CI 92.3–100). AL demonstrated a rapid parasite and fever clearance with no parasitaemia on day 2 and febrile cases on day 3. Gametocyte clearance was complete by day three. No serious adverse events were reported during the 28 days follow-up. Conclusion The study demonstrated high therapeutic efficacy and good safety profile of AL. This suggests the continuation of AL as the first-line drug for the treatment of uncomplicated P. falciparum malaria in Ethiopia. Periodic therapeutic efficacy studies and monitoring of markers of resistance are recommended for early detection of resistant parasites. |
| first_indexed | 2024-04-11T00:24:32Z |
| format | Article |
| id | doaj.art-e118163bd6ad4e5792a327cfede8f826 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-11T00:24:32Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-e118163bd6ad4e5792a327cfede8f8262023-01-08T12:05:26ZengBMCMalaria Journal1475-28752023-01-0122111010.1186/s12936-022-04436-8Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, EthiopiaKale Gubae0Hussein Mohammed1Heven Sime2Henok Hailgiorgis3Anteneh Kassahun Mare4Bokretsion Gidey5Mebrahtom Haile6Gudissa Assefa7Worku Bekele8Geremew Tasew9Solomon Mequanente Abay10Ashenafi Assefa11Department of Pharmacy, College of Health Sciences, Debre Markos UniversityMalaria and Other Parasitological and Entomological Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health InstituteMalaria and Other Parasitological and Entomological Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health InstituteMalaria and Other Parasitological and Entomological Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health InstituteDepartment of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa UniversityMalaria and Other Parasitological and Entomological Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health InstituteEthiopian Ministry of HealthEthiopian Ministry of HealthWorld Health OrganizationMalaria and Other Parasitological and Entomological Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health InstituteDepartment of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa UniversityMalaria and Other Parasitological and Entomological Research Team, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health InstituteAbstract Background In 2004, Ethiopia adopted artemether-lumefantrine (AL, Coartem®) as first-line treatment for the management of uncomplicated Plasmodium falciparum malaria. Continuous monitoring of AL therapeutic efficacy is crucial in Ethiopia, as per the World Health Organization (WHO) recommendation. This study aimed to assess the therapeutic efficacy of AL in the treatment of uncomplicated P. falciparum infection. Methods A 28 day onearm, prospective evaluation of the clinical and parasitological response to AL was conducted at Shecha Health Centre, Arba Minch town, Southern Ethiopia. Patients were treated with six-dose regimen of AL over three days and monitored for 28 days with clinical and laboratory assessments. Participant recruitment and outcome classification was done in accordance with the 2009 WHO methods for surveillance of anti-malarial drug efficacy guidelines. Results A total of 88 study participants were enrolled and 69 of them completed the study with adequate clinical and parasitological response. Two late parasitological failures were observed, of which one was classified as a recrudescence by polymerase chain reaction (PCR). The PCRcorrected cure rate was 98.6% (95% CI 92.3–100). AL demonstrated a rapid parasite and fever clearance with no parasitaemia on day 2 and febrile cases on day 3. Gametocyte clearance was complete by day three. No serious adverse events were reported during the 28 days follow-up. Conclusion The study demonstrated high therapeutic efficacy and good safety profile of AL. This suggests the continuation of AL as the first-line drug for the treatment of uncomplicated P. falciparum malaria in Ethiopia. Periodic therapeutic efficacy studies and monitoring of markers of resistance are recommended for early detection of resistant parasites.https://doi.org/10.1186/s12936-022-04436-8Therapeutic efficacyArtemether-lumefantrineUncomplicated malariaEthiopia |
| spellingShingle | Kale Gubae Hussein Mohammed Heven Sime Henok Hailgiorgis Anteneh Kassahun Mare Bokretsion Gidey Mebrahtom Haile Gudissa Assefa Worku Bekele Geremew Tasew Solomon Mequanente Abay Ashenafi Assefa Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia Malaria Journal Therapeutic efficacy Artemether-lumefantrine Uncomplicated malaria Ethiopia |
| title | Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia |
| title_full | Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia |
| title_fullStr | Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia |
| title_full_unstemmed | Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia |
| title_short | Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia |
| title_sort | safety and therapeutic efficacy of artemether lumefantrine in the treatment of uncomplicated plasmodium falciparum malaria at shecha health centre arba minch ethiopia |
| topic | Therapeutic efficacy Artemether-lumefantrine Uncomplicated malaria Ethiopia |
| url | https://doi.org/10.1186/s12936-022-04436-8 |
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