High efficacy of two artemisinin-based combinations: artesunate + sulfadoxine-pyrimethamine and artemether-lumefantrine for falciparum malaria in Yemen

Malaria Journal

Research

Ahmed A. Adeel¹  Amy Barrette²  Marian Warsame²  Ghasem Zamani³  Hoda Atta³  Yahiya A. Salaeah⁴  Mohammed AlDarsi⁴  Mohamed H. Galab⁴  Amar AlMahdi⁴  Mansor H. Mahammed⁴  Amar M. Almohager⁴  Hanan El Mohammady⁵  Rania A. Nada⁵  Adel Aljasari⁶  Niaz Abdo Saeed⁶ 

[1] College of Medicine, King Saud University, Riyadh, Saudi Arabia;Global Malaria Programme, World Health Organization, Geneva, Switzerland;Malaria Control and Elimination, Division of Communicable Diseases Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt;Ministry of Public Health and Population, Sanaa, Yemen;Naval Medical Research Unit-3, Cairo, Egypt;The National Malaria Control Programme, Ministry of Public Health and Population, Sanaa, Yemen;

关键词: Yemen;    Artesunate;    Sulfadoxine-pyrimethamine;    Anti-malarial drugs;    Drug resistance;    Plasmodium falciparum;    Gametocytaemia;    Artemether-lumefantrine;   

DOI  :  10.1186/s12936-015-0970-2

 received in 2015-09-10, accepted in 2015-10-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundArtesunate + sulfadoxine-pyrimethamine (AS + SP) has been the first-line treatment and artemether-lumefantrine (AL) the second-line treatment for uncomplicated falciparum malaria in Yemen since 2005. This paper reports the results of studies conducted to monitor therapeutic efficacy of these two drugs in sentinel sites in Yemen.MethodsEight therapeutic efficacy studies were conducted in six sentinel sites during the period 2009–2013 in Yemen. Five studies were for the evaluation of AS + SP (total of 465 patients) and three studies (total of 268 patients) for the evaluation of AL. The studies were done according to standard WHO protocol 2009 with 28-day follow-up.ResultsIn the evaluation of AS + SP, the PCR-corrected cure rate was 98 % (95 % CI 92.2–99.5 %) in one site and 100 % in all of the other four sites. In the sites where AL was evaluated, the PCR-corrected cure rate was 100 % in all the sites. All patients were negative for asexual parasitaemia on day 3 in both the AS + SP and the AL groups. There was a higher rate of clearance of gametocytaemia in the AL-treated group when compared with the AS + SP groups from day 7 onwards.ConclusionAS + SP remains the effective drug for uncomplicated falciparum malaria in Yemen. AL is also highly effective and can be an appropriate alternative to AS + SP for the treatment of falciparum malaria. AL demonstrated a higher efficacy in clearing microscopic gametocytaemia than AS + SP.Trial registration: Trial registration number ACTRN12610000696099

【 授权许可】

CC BY   
© Adeel et al. 2015