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Safety monitoring experience of single-low dose primaquine co-administered with artemether–lumefantrine among providers and patients in routine healthcare practice: a qualitative study in Eastern Tanzania

October 23, 2021 - 18:05 -- Open Access
Dominic Mosha, Mwaka A. Kakolwa, Muhidin K. Mahende, Honorati Masanja, Salim Abdulla, Chris Drakeley, Roland Gosling and Joyce Wamoyi
Malaria Journal 2021 20:392, 9 October 2021

Primaquine is a gametocytocidal drug recommended by the World Health Organization (WHO) in a single-low dose combined with artemisinin-based combination therapy (ACT) for the treatment and prevention of Plasmodium falciparum malaria transmission. Safety monitoring concerns and the lack of a universal validated and approved primaquine pharmacovigilance tool is a challenge for a national rollout in many countries. This study aimed to explore the acceptance, reliability and perceived effectiveness of the primaquine roll out monitoring pharmacovigilance tool (PROMPT).

In vivo efficacy and safety of artemether–lumefantrine and amodiaquine–artesunate for uncomplicated Plasmodium falciparum malaria in Mozambique, 2018

October 23, 2021 - 18:01 -- Open Access
Abel Nhama, Lídia Nhamússua, Pedro Aide, et al.
Malaria Journal 2021 20:390, 2 October 2021

Artemisinin-based combination therapy (ACT) has been the recommended first-line treatment for uncomplicated malaria in Mozambique since 2006, with artemether–lumefantrine (AL) and amodiaquine–artesunate (AS–AQ) as the first choice. To assess efficacy of currently used ACT, an in vivo therapeutic efficacy study was conducted.

Therapeutic efficacy of artemether–lumefantrine and artesunate–amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali, 2015–2016

May 26, 2021 - 09:33 -- Open Access
Youssouf Diarra, Oumar Koné, Ousmane A. Koita, et al.
Malaria Journal 2021 20:235, 25 May 2021

The current first-line treatments for uncomplicated malaria recommended by the National Malaria Control Programme in Mali are artemether–lumefantrine (AL) and artesunate–amodiaquine (ASAQ). From 2015 to 2016, an in vivo study was carried out to assess the clinical and parasitological responses to AL and ASAQ in Sélingué, Mali.

Efficacy and safety of artemether–lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia: a systematic review and meta-analysis

May 12, 2021 - 10:08 -- Open Access
Abdulhakim Abamecha, Daniel Yilma, Wondimagegn Adissu, Delenasaw Yewhalaw and Alemseged Abdissa
Malaria Journal 2021 20:213, 6 May 2021

Regular monitoring of anti-malarial drug efficacy is vital for establishing rational malaria treatment guidelines and ensuring adequate treatment outcomes. This study aimed to synthesize the available evidence on the efficacy of artemether–lumefantrine for the management of uncomplicated falciparum malaria in Ethiopia.

NOT Open Access | Association of Plasmodium falciparum kelch13 R561H genotypes with delayed parasite clearance in Rwanda: an open-label, single-arm, multicentre, therapeutic efficacy study

April 22, 2021 - 08:46 -- NOT Open Access
Uwimana A, Umulisa N, Lucchi NW, et al.
Lancet Infect Dis. 2021 Apr 14:S1473-3099(21)00142-0

Partial artemisinin resistance is suspected if delayed parasite clearance (ie, persistence of parasitaemia on day 3 after treatment initiation) is observed. Validated markers of artemisinin partial resistance in southeast Asia, Plasmodium falciparum kelch13 (Pfkelch13) R561H and P574L, have been reported in Rwanda but no association with parasite clearance has been observed. We aimed to establish the efficacy of artemether–lumefantrine and genetic characterisation of Pfkelch13 alleles and their association with treatment outcomes.

Efficacy and safety of dihydroartemisinin–piperaquine versus artemether–lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Ugandan children: a systematic review and meta-analysis of randomized control trials

April 7, 2021 - 12:49 -- Open Access
Dawit Getachew Assefa, Eden Dagnachew Zeleke, Delayehu Bekele, Hanna Amanuel Tesfahunei, Emnet Getachew, Michele Joseph and Tsegahun Manyazewal
Malaria Journal 2021 20:174, 1 April 2021

The emergence of artemisinin resistance in Southeast Asia and Plasmodium falciparum kelch13 propeller gene mutations in sub-Saharan African pose the greatest threat to global efforts to control malaria. This is a critical concern in Uganda, where artemisinin-based combination therapy (ACT) is the first-line treatment for uncomplicated falciparum. The objective of this study was to compare the efficacy and safety of dihydroartemisinin–piperaquine (DHA–PQ) and artemether–lumefantrine (AL) for the treatment of uncomplicated falciparum malaria in Ugandan children.

Hepatic safety of repeated treatment with pyronaridine‐artesunate versus artemether–lumefantrine in patients with uncomplicated malaria: a secondary analysis of the WANECAM 1 data from Bobo-Dioulasso, Burkina Faso

February 3, 2021 - 15:08 -- Open Access
Yves Daniel Compaoré, Issaka Zongo, Jean Bosco Ouédraogo, et al.
Malaria Journal 2021 20:64, 29 January 2021

The use of pyronaridine-artesunate (PA) has been associated with scarce transaminitis in patients. This analysis aimed to evaluate the hepatic safety profile of repeated treatment with PA versus artemether–lumefantrine (AL) in patients with consecutive uncomplicated malaria episodes in Bobo-Dioulasso, Burkina Faso.

Asymptomatic recrudescence after artemether–lumefantrine treatment for uncomplicated falciparum malaria: a systematic review and meta-analysis

December 15, 2020 - 16:04 -- Open Access
Rida Mumtaz, Lucy C. Okell and Joseph D. Challenger
Malaria Journal 2020 19:453, 9 December 2020

In clinical trials of therapy for uncomplicated Plasmodium falciparum, there are usually some patients who fail treatment even in the absence of drug resistance. Treatment failures, which can be due to recrudescence or re-infection, are categorized as ‘clinical’ or ‘parasitological’ failures, the former indicating that symptoms have returned. Asymptomatic recrudescence has public health implications for continued malaria transmission and may be important for the spread of drug-resistant malaria. As the number of recrudescences in an individual trial is often low, it is difficult to assess how commonplace asymptomatic recrudescence is, and with what factors it is associated.

Parasite clearance, cure rate, post-treatment prophylaxis and safety of standard 3-day versus an extended 6-day treatment of artemether–lumefantrine and a single low-dose primaquine for uncomplicated Plasmodium falciparum malaria in Bagamoyo district, Tan

June 26, 2020 - 15:41 -- Open Access
Lwidiko E. Mhamilawa, Billy Ngasala, Ulrika Morris, Eliford Ngaimisi Kitabi, Rory Barnes, Aung Paing Soe, Bruno P. Mmbando, Anders Björkman and Andreas Mårtensson
Malaria Journal 2020 19:216, 23 June 2020

Artemisinin-based combination therapy (ACT) resistant Plasmodium falciparum represents an increasing threat to Africa. Extended ACT regimens from standard 3 to 6 days may represent a means to prevent its development and potential spread in Africa.

Efficacy and safety of artesunate–amodiaquine and artemether–lumefantrine and prevalence of molecular markers associated with resistance, Guinea: an open-label two-arm randomised controlled trial

June 26, 2020 - 11:07 -- Open Access
Abdoul Habib Beavogui, Alioune Camara, Mateusz M. Plucinski, et al.
Malaria Journal 2020 19:223, 24 June 2020

Anti-malarial resistance is a threat to recent gains in malaria control. This study aimed to assess the efficacy and safety of artesunate–amodiaquine (ASAQ) and artemether–lumefantrine (AL) in the management of uncomplicated malaria and to measure the prevalence of molecular markers of resistance of Plasmodium falciparum in sentinel sites in Maferinyah and Labé Health Districts in Guinea in 2016.


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