Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian children
Introduction: The development and spread of Plasmodium falciparum resistance to most commonly used antimalarials remain a major challenge in the control of malaria. Constant monitoring of drug efficacy is an important tool in establishing rational antimalarial drug policies. Methodology: A randomiz...
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The Journal of Infection in Developing Countries
2013-12-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/3058 |
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| author | Olusola Ojurongbe Olubunmi A Lawal Oyindamola O Abiodun John A Okeniyi Ayobami J Oyeniyi Oyeku A Oyelami |
| author_facet | Olusola Ojurongbe Olubunmi A Lawal Oyindamola O Abiodun John A Okeniyi Ayobami J Oyeniyi Oyeku A Oyelami |
| author_sort | Olusola Ojurongbe |
| collection | DOAJ |
| description | Introduction: The development and spread of Plasmodium falciparum resistance to most commonly used antimalarials remain a major challenge in the control of malaria. Constant monitoring of drug efficacy is an important tool in establishing rational antimalarial drug policies.
Methodology: A randomized comparative study was conducted at the Wesley Guild Hospital, Ilesa, Nigeria between February 2010 and September 2011 comparing the efficacy and safety of artemether-lumefantrine (Coartem) and fixed dose of artesunate plus amodiaquine (Larimal) in the treatment of uncomplicated P. falciparum malaria in children betweem 6 and 144 months of age. P. falciparum malaria parasitemia was assessed by microscopy and rapid diagnostic test. Drugs were administered according to age for three days under supervision. The primary efficacy endpoint was a day 28 PCR-corrected parasitological cure.
Results: A total of 182 patients were enrolled in the two treatment groups, Coartem (n = 101) and Larimal (n = 81), and tested after 28 days. In the intention-to-treat population, Coartem (n= 101) and Larimal (n= 81) had a PCR-corrected cure rate of 98% and 100% respectively, while in the per-protocol population, Coartem (n = 89) and Larimal (n = 71) both had a PCR-corrected cure rate of 100% at day 28. Although parasite and fever clearance time was faster in the Larimal group, no significant difference was observed between the two drugs. No serious adverse effects were reported.
Conclusion: Five years after being introduced in Nigeria, both Coartem and Larimal have been shown to be safe and highly effective in the treatment of uncomplicated P. falciparum malaria in children.
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| format | Article |
| id | doaj-art-49e08469e1374758b3f2e799f667bf2c |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2013-12-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-49e08469e1374758b3f2e799f667bf2c2025-08-20T02:27:06ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802013-12-0171210.3855/jidc.3058Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian childrenOlusola Ojurongbe0Olubunmi A Lawal1Oyindamola O Abiodun2John A Okeniyi3Ayobami J Oyeniyi4Oyeku A Oyelami5Ladoke Akintola University of Technology, Osogbo, NigeriaWesley Guild Hospital, Ilesa, NigeriaCollege of Medicine, University of Ibadan, Ibadan, NigeriaWesley Guild Hospital, Ilesa, NigeriaWesley Guild Hospital, Ilesa, NigeriaWesley Guild Hospital, Ilesa, NigeriaIntroduction: The development and spread of Plasmodium falciparum resistance to most commonly used antimalarials remain a major challenge in the control of malaria. Constant monitoring of drug efficacy is an important tool in establishing rational antimalarial drug policies. Methodology: A randomized comparative study was conducted at the Wesley Guild Hospital, Ilesa, Nigeria between February 2010 and September 2011 comparing the efficacy and safety of artemether-lumefantrine (Coartem) and fixed dose of artesunate plus amodiaquine (Larimal) in the treatment of uncomplicated P. falciparum malaria in children betweem 6 and 144 months of age. P. falciparum malaria parasitemia was assessed by microscopy and rapid diagnostic test. Drugs were administered according to age for three days under supervision. The primary efficacy endpoint was a day 28 PCR-corrected parasitological cure. Results: A total of 182 patients were enrolled in the two treatment groups, Coartem (n = 101) and Larimal (n = 81), and tested after 28 days. In the intention-to-treat population, Coartem (n= 101) and Larimal (n= 81) had a PCR-corrected cure rate of 98% and 100% respectively, while in the per-protocol population, Coartem (n = 89) and Larimal (n = 71) both had a PCR-corrected cure rate of 100% at day 28. Although parasite and fever clearance time was faster in the Larimal group, no significant difference was observed between the two drugs. No serious adverse effects were reported. Conclusion: Five years after being introduced in Nigeria, both Coartem and Larimal have been shown to be safe and highly effective in the treatment of uncomplicated P. falciparum malaria in children. https://jidc.org/index.php/journal/article/view/3058ACTsdrug resistanceNigeriaPlasmodium falciparum |
| spellingShingle | Olusola Ojurongbe Olubunmi A Lawal Oyindamola O Abiodun John A Okeniyi Ayobami J Oyeniyi Oyeku A Oyelami Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian children Journal of Infection in Developing Countries ACTs drug resistance Nigeria Plasmodium falciparum |
| title | Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian children |
| title_full | Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian children |
| title_fullStr | Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian children |
| title_full_unstemmed | Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian children |
| title_short | Efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in Nigerian children |
| title_sort | efficacy of artemisinin combination therapy for the treatment of uncomplicated falciparum malaria in nigerian children |
| topic | ACTs drug resistance Nigeria Plasmodium falciparum |
| url | https://jidc.org/index.php/journal/article/view/3058 |
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