Efficacy of artemether-lumefantrine versus dihydroartemisinin-piperaquine for the treatment of uncomplicated malaria among children in Rwanda : an open-label, randomized controlled trial
© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: Artemisinin-based combination therapies (ACTs) have proven highly effective in reducing malaria morbidity in sub-Saharan Africa. Artemether-lumefantrine (AL) was introduced in 2005 as a first-line ACT for the treatment of uncomplicated malaria in Rwanda. Monitoring the therapeutic efficacy of ACTs is necessary to ensure effective malaria case management.
METHODS: A comparative study on the efficacy of AL and dihydroartemisinin-piperaquine (DHP) was conducted in two sites, Masaka and Ruhuha, between September 2013 and December 2015. Clinical and parasitological responses were assessed at days 28 and 42.
RESULTS: A total of 534 children were treated with AL (n=267) or DHP (n=267). After polymerase chain reaction (PCR) adjustment, 98.3% and 98.9% of children in the AL and DHP arms, respectively, achieved an adequate clinical and parasitological response (ACPR) at day 28. At day 42, PCR-adjusted ACPR proportions were 97.3% and 98.4% for AL and DHP, respectively. PCR-adjusted ACPR was 99% for both drugs at days 28 and 42 in Ruhuha. The PCR-adjusted ACPR proportions in Masaka were 97.3% for AL and 98.5% for DHP at day 28 and 95.2% for AL and 97.5% for DHP at day 42.
CONCLUSIONS: AL remains efficacious in Rwanda 10 y after its adoption. The probability of new infections occurring among patients in the DHP arm was significantly lower than those in the AL arm. DHP also demonstrated a greater post-treatment prophylactic effect against new infections compared with AL.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:113 |
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| Enthalten in: |
Transactions of the Royal Society of Tropical Medicine and Hygiene - 113(2019), 6 vom: 01. Juni, Seite 312-319 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Uwimana, Aline [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 26.06.2020 Date Revised 29.01.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/trstmh/trz009 |
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| Förderinstitution / Projekttitel: |
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NLM29515408X |
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| 100 | 1 | |a Uwimana, Aline |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Efficacy of artemether-lumefantrine versus dihydroartemisinin-piperaquine for the treatment of uncomplicated malaria among children in Rwanda |b an open-label, randomized controlled trial |
| 264 | 1 | |c 2019 | |
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| 500 | |a Date Revised 29.01.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Artemisinin-based combination therapies (ACTs) have proven highly effective in reducing malaria morbidity in sub-Saharan Africa. Artemether-lumefantrine (AL) was introduced in 2005 as a first-line ACT for the treatment of uncomplicated malaria in Rwanda. Monitoring the therapeutic efficacy of ACTs is necessary to ensure effective malaria case management | ||
| 520 | |a METHODS: A comparative study on the efficacy of AL and dihydroartemisinin-piperaquine (DHP) was conducted in two sites, Masaka and Ruhuha, between September 2013 and December 2015. Clinical and parasitological responses were assessed at days 28 and 42 | ||
| 520 | |a RESULTS: A total of 534 children were treated with AL (n=267) or DHP (n=267). After polymerase chain reaction (PCR) adjustment, 98.3% and 98.9% of children in the AL and DHP arms, respectively, achieved an adequate clinical and parasitological response (ACPR) at day 28. At day 42, PCR-adjusted ACPR proportions were 97.3% and 98.4% for AL and DHP, respectively. PCR-adjusted ACPR was 99% for both drugs at days 28 and 42 in Ruhuha. The PCR-adjusted ACPR proportions in Masaka were 97.3% for AL and 98.5% for DHP at day 28 and 95.2% for AL and 97.5% for DHP at day 42 | ||
| 520 | |a CONCLUSIONS: AL remains efficacious in Rwanda 10 y after its adoption. The probability of new infections occurring among patients in the DHP arm was significantly lower than those in the AL arm. DHP also demonstrated a greater post-treatment prophylactic effect against new infections compared with AL | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Rwanda | |
| 650 | 4 | |a antimalarial resistance monitoring | |
| 650 | 4 | |a artemisinin-based combination therapy | |
| 650 | 4 | |a malaria | |
| 650 | 4 | |a sub-Saharan Africa | |
| 650 | 7 | |a Antimalarials |2 NLM | |
| 650 | 7 | |a Artemether, Lumefantrine Drug Combination |2 NLM | |
| 650 | 7 | |a Artemisinins |2 NLM | |
| 650 | 7 | |a Quinolines |2 NLM | |
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| 650 | 7 | |a piperaquine |2 NLM | |
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| 700 | 1 | |a Nisingizwe, Marie Paul |e verfasserin |4 aut | |
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| 700 | 1 | |a Ntagwabira, Edouard |e verfasserin |4 aut | |
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| 700 | 1 | |a Muvunyi, Claude Mambo |e verfasserin |4 aut | |
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| 700 | 1 | |a Kabera, Michee |e verfasserin |4 aut | |
| 700 | 1 | |a Murindahabi, Monique |e verfasserin |4 aut | |
| 700 | 1 | |a Mbituyumuremyi, Aimable |e verfasserin |4 aut | |
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