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Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia

BACKGROUND: Artemether/Lumefantrine (Coartem(®)) has been used as a first-line treatment for uncomplicated Plasmodium falciparum infection since 2004 in Ethiopia. In the present study the therapeutic efficacy of artemether/lumefantrine for the treatment of uncomplicated P. falciparum infection at Ke...

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Autores principales: Assefa, Ashenafi, Kassa, Moges, Tadese, Gemechu, Mohamed, Hussen, Animut, Abebe, Mengesha, Tesfayae
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881066/
https://www.ncbi.nlm.nih.gov/pubmed/20051120
http://dx.doi.org/10.1186/1756-3305-3-1
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author Assefa, Ashenafi
Kassa, Moges
Tadese, Gemechu
Mohamed, Hussen
Animut, Abebe
Mengesha, Tesfayae
author_facet Assefa, Ashenafi
Kassa, Moges
Tadese, Gemechu
Mohamed, Hussen
Animut, Abebe
Mengesha, Tesfayae
author_sort Assefa, Ashenafi
collection PubMed
description BACKGROUND: Artemether/Lumefantrine (Coartem(®)) has been used as a first-line treatment for uncomplicated Plasmodium falciparum infection since 2004 in Ethiopia. In the present study the therapeutic efficacy of artemether/lumefantrine for the treatment of uncomplicated P. falciparum infection at Kersa, Jima zone, South-west Ethiopia, has been assessed. METHODS: A 28 day therapeutic efficacy study was conducted between November 2007 and January 2008, in accordance with the 2003 WHO guidelines. Outcomes were classified as early treatment failure (ETF), late clinical failure (LCF), late parasitological failure (LPF) and adequate clinical and parasitological response (ACPR). RESULTS: 90 patients were enrolled and completed the 28 day follow-up period after treatment with artemether/lumefantrine. Cure rate was very high, 96.3%, with 95% CI of 0.897-0.992 (PCR uncorrected). Age-stratified data showed adequate clinical and parasitological response (ACPR) to be 100% for children under 5 and 97.4% and 87.3% for children aged 5-14, and adults, respectively. There was no early treatment failure (ETF) in all age groups. Fever was significantly cleared on day 3 (P < 0.05) and 98% of parasites where cleared on day 1 and almost all parasites were cleared on day 3. 72.5% of gametocytes were cleared on day 1, the remaining 27.5% of gametocytes were maintained up to day 3 and total clearance was observed on day 7. Hemoglobin concentration showed a slight increase with parasitic clearance (P > 0.05). No major side effect was observed in the study except the occurrence of mouth ulcers in 7% of the patients. CONCLUSIONS: The current study proved the excellent therapeutic efficacy of artemether/lumefantrine in the study area and the value of using it. However, the proper dispensing and absorption of the drug need to be emphasized in order to utilize the drug for a longer period of time. This study recommends further study on the toxicity of the drug with particular emphasis on the development of oral ulcers in children.
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spelling pubmed-28810662010-06-05 Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia Assefa, Ashenafi Kassa, Moges Tadese, Gemechu Mohamed, Hussen Animut, Abebe Mengesha, Tesfayae Parasit Vectors Research BACKGROUND: Artemether/Lumefantrine (Coartem(®)) has been used as a first-line treatment for uncomplicated Plasmodium falciparum infection since 2004 in Ethiopia. In the present study the therapeutic efficacy of artemether/lumefantrine for the treatment of uncomplicated P. falciparum infection at Kersa, Jima zone, South-west Ethiopia, has been assessed. METHODS: A 28 day therapeutic efficacy study was conducted between November 2007 and January 2008, in accordance with the 2003 WHO guidelines. Outcomes were classified as early treatment failure (ETF), late clinical failure (LCF), late parasitological failure (LPF) and adequate clinical and parasitological response (ACPR). RESULTS: 90 patients were enrolled and completed the 28 day follow-up period after treatment with artemether/lumefantrine. Cure rate was very high, 96.3%, with 95% CI of 0.897-0.992 (PCR uncorrected). Age-stratified data showed adequate clinical and parasitological response (ACPR) to be 100% for children under 5 and 97.4% and 87.3% for children aged 5-14, and adults, respectively. There was no early treatment failure (ETF) in all age groups. Fever was significantly cleared on day 3 (P < 0.05) and 98% of parasites where cleared on day 1 and almost all parasites were cleared on day 3. 72.5% of gametocytes were cleared on day 1, the remaining 27.5% of gametocytes were maintained up to day 3 and total clearance was observed on day 7. Hemoglobin concentration showed a slight increase with parasitic clearance (P > 0.05). No major side effect was observed in the study except the occurrence of mouth ulcers in 7% of the patients. CONCLUSIONS: The current study proved the excellent therapeutic efficacy of artemether/lumefantrine in the study area and the value of using it. However, the proper dispensing and absorption of the drug need to be emphasized in order to utilize the drug for a longer period of time. This study recommends further study on the toxicity of the drug with particular emphasis on the development of oral ulcers in children. BioMed Central 2010-01-05 /pmc/articles/PMC2881066/ /pubmed/20051120 http://dx.doi.org/10.1186/1756-3305-3-1 Text en Copyright ©2010 Assefa et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Assefa, Ashenafi
Kassa, Moges
Tadese, Gemechu
Mohamed, Hussen
Animut, Abebe
Mengesha, Tesfayae
Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia
title Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia
title_full Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia
title_fullStr Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia
title_full_unstemmed Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia
title_short Therapeutic efficacy of Artemether/Lumefantrine (Coartem(®)) against Plasmodium falciparum in Kersa, South West Ethiopia
title_sort therapeutic efficacy of artemether/lumefantrine (coartem(®)) against plasmodium falciparum in kersa, south west ethiopia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881066/
https://www.ncbi.nlm.nih.gov/pubmed/20051120
http://dx.doi.org/10.1186/1756-3305-3-1
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