Prospective evaluation of artemether-lumefantrine for the treatment of non-falciparum and mixed-species malaria in Gabon

Abstract Background The recommendation of artemisinin combination therapy (ACT) as first-line treatment for uncomplicated falciparum malaria is supported by a plethora of high quality clinical trials. However, their recommendation for the treatment of mixed-species malaria and the large-scale use fo...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Mombo-Ngoma Ghyslain, Kleine Christian, Basra Arti, Würbel Heike, Diop Daisy A, Capan Mesküre, Adegnika Ayola A, Kurth Florian, Mordmüller Benjamin, Joanny Fanny, Kremsner Peter G, Ramharter Michael, Bélard Sabine
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2012
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Online Access:https://doi.org/10.1186/1475-2875-11-120
https://doaj.org/article/86bf4218a1c648dcb76418dcef7eac95
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Summary:Abstract Background The recommendation of artemisinin combination therapy (ACT) as first-line treatment for uncomplicated falciparum malaria is supported by a plethora of high quality clinical trials. However, their recommendation for the treatment of mixed-species malaria and the large-scale use for the treatment of non-falciparum malaria in endemic regions is based on anecdotal rather than systematic clinical evidence. Methods This study prospectively observed the efficacy of artemether-lumefantrine for the treatment of uncomplicated non-falciparum or mixed-species malaria in two routine district hospitals in the Central African country of Gabon. Results Forty patients suffering from uncomplicated Plasmodium malariae, Plasmodium ovale or mixed-species malaria (including Plasmodium falciparum ) presenting at the hospital received artemether-lumefantrine treatment and were followed up. All evaluable patients (n = 38) showed an adequate clinical and parasitological response on Day 28 after oral treatment with artemether-lumefantrine (95% confidence interval: 0.91,1). All adverse events were of mild to moderate intensity and completely resolved by the end of study. Conclusions This first systematic assessment of artemether-lumefantrine treatment for P. malariae , P. ovale and mixed-species malaria demonstrated a high cure rate of 100% and a favourable tolerability profile, and thus lends support to the practice of treating non-falciparum or mixed-species malaria, or all cases of malaria without definite species differentiation, with artemether-lumefantrine in Gabon. Trial Registration ClinicalTrials.gov Identifier: NCT00725777