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Published in: Malaria Journal 1/2015

Open Access 01-12-2015 | Research

Assessment of therapeutic efficacy and safety of artemether-lumefantrine (Coartem®) in the treatment of uncomplicated Plasmodium falciparum malaria patients in Bahir Dar district, Northwest Ethiopia: an observational cohort study

Authors: Yehenew A. Ebstie, Ahmed Zeynudin, Tefera Belachew, Zelalem Desalegn, Sultan Suleman

Published in: Malaria Journal | Issue 1/2015

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Abstract

Background

Malaria is a complex disease, which varies in its epidemiology and clinical manifestation. Although artemether-lumefantrine has been used as first-line drug for uncomplicated Plasmodium falciparum malaria in Bahir Dar district since 2004, its efficacy has not yet been assessed. The main objective of this study was to quantify the proportion of patients with uncomplicated falciparum malaria who were prescribed artemether-lumefantrine and who failed treatment after a 28-day follow-up.

Methods

The research team attempted to conduct an observational cohort study on the assessment of therapeutic efficacy and safety of artemether-lumefantrine in falciparum malaria patients aged over five years in Bahir Dar district from March to July 2012.

Results

Among 130 participants in the study, 60 % were males with 1:5 male to female ratio. The mean of asexual parasitaemia load was 8675 parasites/μL and 96.1 % participants were free from parasitaemia at day 3. At the end of the study, 98.5 % of participants showed adequate clinical and parasitological response of the drug. In the study, only 1.5 % of participants were shown late parasitological failure between seventh and 14th day follow-up and 1.3 % of participants were free from anaemia at the end of follow-up.

Conclusion

According to the research findings, artemether-lumefantrine fulfilled the inclusion criteria of WHO as first-line drug and continues to be the drug of choice for the treatment of uncomplicated falciparum malaria. Outputs from this study should be supported through advanced molecular techniques and blood concentration and pharmaco-vigilance of the drug.
Literature
6.
go back to reference Wongsrichanalai C, Pickard AL, Wernsdorfer WH, Meshnick SR. Epidemiology of drug-resistant malaria. Lancet Infect Dis. 2002;2:209–18.PubMedCrossRef Wongsrichanalai C, Pickard AL, Wernsdorfer WH, Meshnick SR. Epidemiology of drug-resistant malaria. Lancet Infect Dis. 2002;2:209–18.PubMedCrossRef
7.
go back to reference WHO. The Africa malaria report. Geneva: World Health Organization press; 2003. WHO. The Africa malaria report. Geneva: World Health Organization press; 2003.
9.
go back to reference Vestergaard LS, Ringwald P. Responding to the challenge of anti-malarial drug resistance by routine monitoring to update national malaria treatment policies. Am J Trop Med Hyg. 2007;77:153–9.PubMed Vestergaard LS, Ringwald P. Responding to the challenge of anti-malarial drug resistance by routine monitoring to update national malaria treatment policies. Am J Trop Med Hyg. 2007;77:153–9.PubMed
11.
go back to reference Lefèvre G, Looareesuwan S, Treeprasertsuk S, Krudsood S, Silachamroon U, Gathmann I, et al. A clinical and pharmacokinetic trial of six doses of artemether-lumefantrine for multidrug-resistant Plasmodium falciparum malaria in Thailand. Am J Trop Med Hyg. 2001;64:247–56.PubMed Lefèvre G, Looareesuwan S, Treeprasertsuk S, Krudsood S, Silachamroon U, Gathmann I, et al. A clinical and pharmacokinetic trial of six doses of artemether-lumefantrine for multidrug-resistant Plasmodium falciparum malaria in Thailand. Am J Trop Med Hyg. 2001;64:247–56.PubMed
14.
go back to reference Fanello CI, Karema C, Van Doren W, Van Overmeir C, Ngamije D, D’Alessandro U. A randomised trial to assess the safety and efficacy of artemether-lumefantrine (Coartem®) for the treatment of uncomplicated Plasmodium falciparum malaria in Rwanda. Trans R Soc Trop Med Hyg. 2007;101:344–50.PubMedCrossRef Fanello CI, Karema C, Van Doren W, Van Overmeir C, Ngamije D, D’Alessandro U. A randomised trial to assess the safety and efficacy of artemether-lumefantrine (Coartem®) for the treatment of uncomplicated Plasmodium falciparum malaria in Rwanda. Trans R Soc Trop Med Hyg. 2007;101:344–50.PubMedCrossRef
15.
go back to reference Assefa A, Kassa M, Tadese G, Mohamed H, Animut A, Mengesha T. Therapeutic efficacy of artemether/lumefantrine (Coartem®) against Plasmodium falciparum in Kersa, South West Ethiopia. Parasit Vectors. 2010;3:1–4.PubMedCentralPubMedCrossRef Assefa A, Kassa M, Tadese G, Mohamed H, Animut A, Mengesha T. Therapeutic efficacy of artemether/lumefantrine (Coartem®) against Plasmodium falciparum in Kersa, South West Ethiopia. Parasit Vectors. 2010;3:1–4.PubMedCentralPubMedCrossRef
16.
go back to reference Sisowath C, Strömberg J, Mårtensson A, Msellem M, Obondo C, Björkman A, et al. In vivo Selection of Plasmodium falciparum pfmdr1 86 N coding alleles by Artemether-Lumefantrine (Coartem®). J Infect Dis. 2005;191:1014–27.PubMedCrossRef Sisowath C, Strömberg J, Mårtensson A, Msellem M, Obondo C, Björkman A, et al. In vivo Selection of Plasmodium falciparum pfmdr1 86 N coding alleles by Artemether-Lumefantrine (Coartem®). J Infect Dis. 2005;191:1014–27.PubMedCrossRef
17.
go back to reference Mizuno Y, Kato Y, Kudo K, Kano S. First case of treatment failure of artemether-lumefantrine in a Japanese traveler with imported falciparum malaria. Jpn J Infect Dis. 2009;62:139–41.PubMed Mizuno Y, Kato Y, Kudo K, Kano S. First case of treatment failure of artemether-lumefantrine in a Japanese traveler with imported falciparum malaria. Jpn J Infect Dis. 2009;62:139–41.PubMed
20.
go back to reference Bukirwa H, Yeka A, Kamya MR, Talisuna A, Banek K, Bakyaita N, et al. Artemisinin combination therapies for treatment of uncomplicated malaria in Uganda. PLoS Clin Trials. 2006;1:e7.PubMedCentralPubMedCrossRef Bukirwa H, Yeka A, Kamya MR, Talisuna A, Banek K, Bakyaita N, et al. Artemisinin combination therapies for treatment of uncomplicated malaria in Uganda. PLoS Clin Trials. 2006;1:e7.PubMedCentralPubMedCrossRef
21.
go back to reference Targett G, Drakeley C, Jawara M, von Seidlein L, Coleman R, Deen J, et al. Artesunate reduces but does not prevent post treatment transmission of Plasmodium falciparum to Anopheles gambiae. J Infect Dis. 2001;183:1254–9.PubMedCrossRef Targett G, Drakeley C, Jawara M, von Seidlein L, Coleman R, Deen J, et al. Artesunate reduces but does not prevent post treatment transmission of Plasmodium falciparum to Anopheles gambiae. J Infect Dis. 2001;183:1254–9.PubMedCrossRef
22.
go back to reference Sim F, Mackie P. Artemisinin combination therapies. Lancet. 2006;367:2037–9.CrossRef Sim F, Mackie P. Artemisinin combination therapies. Lancet. 2006;367:2037–9.CrossRef
23.
go back to reference Sagara I, Dicko A, Djimde A, Guindo O, Kone M, Tolo Y, et al. A randomized trial of artesunate–sulfamethoxypyrazine pyrimethamine versus artemether–lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali. Am J Trop Med Hyg. 2006;75:630–6.PubMed Sagara I, Dicko A, Djimde A, Guindo O, Kone M, Tolo Y, et al. A randomized trial of artesunate–sulfamethoxypyrazine pyrimethamine versus artemether–lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali. Am J Trop Med Hyg. 2006;75:630–6.PubMed
24.
go back to reference Mulenga M, Van Geertruyden JP, Mwananyanda L, Chalwe V, Moerman F, Chilengi R, et al. Safety and efficacy of lumefantrine-artemether (Coartem®) for the treatment of uncomplicated Plasmodium falciparum malaria in Zambian adults. Malar J. 2006;5:73.PubMedCentralPubMedCrossRef Mulenga M, Van Geertruyden JP, Mwananyanda L, Chalwe V, Moerman F, Chilengi R, et al. Safety and efficacy of lumefantrine-artemether (Coartem®) for the treatment of uncomplicated Plasmodium falciparum malaria in Zambian adults. Malar J. 2006;5:73.PubMedCentralPubMedCrossRef
25.
go back to reference Guthmann JP, Cohuet S, Rigutto C, Fortes F, Saraiva N. High efficacy of two artemisinin-based combinations (artesunate + amodiaquine and artemether-lumefantrine) in Caala, central Angola. Am J Trop Med Hyg. 2006;75:143–5.PubMed Guthmann JP, Cohuet S, Rigutto C, Fortes F, Saraiva N. High efficacy of two artemisinin-based combinations (artesunate + amodiaquine and artemether-lumefantrine) in Caala, central Angola. Am J Trop Med Hyg. 2006;75:143–5.PubMed
26.
go back to reference Erko B, Tedla S, Petros B. Transmission of intestinal schistosomiasis in Bahir Dar, northwest Ethiopia. Ethiop Med J. 1991;29:199–211.PubMed Erko B, Tedla S, Petros B. Transmission of intestinal schistosomiasis in Bahir Dar, northwest Ethiopia. Ethiop Med J. 1991;29:199–211.PubMed
27.
go back to reference Erko B, Medhin G, Birrhie H. Intestinal parasitic infection in Bahir Dar and risk factors for transmission. Trop Med. 1995;37:73–8. Erko B, Medhin G, Birrhie H. Intestinal parasitic infection in Bahir Dar and risk factors for transmission. Trop Med. 1995;37:73–8.
Metadata
Title
Assessment of therapeutic efficacy and safety of artemether-lumefantrine (Coartem®) in the treatment of uncomplicated Plasmodium falciparum malaria patients in Bahir Dar district, Northwest Ethiopia: an observational cohort study
Authors
Yehenew A. Ebstie
Ahmed Zeynudin
Tefera Belachew
Zelalem Desalegn
Sultan Suleman
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2015
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-015-0744-x

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