Publication: Efficacy of artemether-lumefantrine, the nationally-recommended artemisinin combination for the treatment of uncomplicated falciparum malaria, in southern Laos.
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Accepted Date
2012-05-24
Issued Date
2012-06-8
Copyright Date
2012
Resource Type
Language
eng
ISSN
1475-2875 (electronic)
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Mahidol University
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BioMed Central
Bibliographic Citation
Mayxay M, Khanthavong M, Chanthongthip O, Imwong M, Pongvongsa T, Hongvanthong B, et al. Efficacy of artemether-lumefantrine, the nationally-recommended artemisinin combination for the treatment of uncomplicated falciparum malaria, in southern Laos. Malar J. 2012 Jun 8;11:184.
Suggested Citation
Mayfong Mayxay, Maniphone Khanthavong, Odai Chanthongthip, Mallika Imwong, มัลลิกา อิ่มวงศ์, Tiengkham Pongvongsa, Bouasy Hongvanthong, Samalane Phompida, Viengxay Vanisaveth, White, Nicholas J., Newton, Paul N Efficacy of artemether-lumefantrine, the nationally-recommended artemisinin combination for the treatment of uncomplicated falciparum malaria, in southern Laos.. Mayxay M, Khanthavong M, Chanthongthip O, Imwong M, Pongvongsa T, Hongvanthong B, et al. Efficacy of artemether-lumefantrine, the nationally-recommended artemisinin combination for the treatment of uncomplicated falciparum malaria, in southern Laos. Malar J. 2012 Jun 8;11:184.. doi:10.1186/1475-2875-11-184 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/680
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Title
Efficacy of artemether-lumefantrine, the nationally-recommended artemisinin combination for the treatment of uncomplicated falciparum malaria, in southern Laos.
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Abstract
BACKGROUND: The Lao Government changed the national policy for uncomplicated
Plasmodium falciparum malaria from chloroquine to artemether-lumefantrine (AL) in
2005. Since then, no information on AL efficacy has been reported. With evidence
of resistance to artemisinin derivatives in adjacent Cambodia, there has been a
concern as to AL efficacy. Monitoring of AL efficacy would help the Lao
Government to make decisions on appropriate malaria treatment.
METHODS: The efficacy of a three-day, twice daily oral artemether-lumefantrine
for the treatment of uncomplicated falciparum malaria in Xepon District,
Savannakhet Province, southern Laos was studied over 42 days follow-up. This was
part of a trial of thiamin supplementation in falciparum malaria.
RESULTS: Of 630 patients with P. falciparum enrolled in the trial of thiamin
treatment, 549 (87%, 357 children ≤15 years and 192 adults) were included in this
study. The per protocol 42-day cure rates were 97% (524/541) [96% (337/352) for
children and 99% (187/189) for adults, p = 0.042]. By conventional
intention-to-treat analysis, the 42-day cure rates adjusted for re-infection,
were 97% (532/549) [96% (342/357) in children and 99% (190/192) in adults,
p = 0.042]. The proportion of patients who remained parasitaemic at day 1 after
treatment was significantly higher in children [33% (116/356)] compared to adults
[15% (28/192)] (p < 0.001) and only one adult patient had detectable parasitaemia
on day 2. There were no serious adverse events. Potential side effects after
treatment were reported more commonly in adults (32%) compared to children (15%)
(p < 0.001). Patients with recrudescent infections were significantly younger,
had longer mean time to fever clearance, and had longer median time to parasite
clearance compared to those who were cured.
CONCLUSIONS: The current nationally-recommended anti-malarial treatment
(artemether-lumefantrine) remains highly efficacious for the treatment of
uncomplicated falciparum malaria five years after introduction in Laos. Regular
monitoring is required in case artemisinin-resistant P. falciparum parasites
should appear.