Abstract
Efficacy of artemether-lumefantrine in treatment of malaria among under-fives and prevalence of drug resistance markers in Igombe-Mwanza, north-western Tanzania
Highlights
Drug resistance to anti-malarials is a major public health problem worldwide
Malaria led to 863,000 deaths in 2008 and 89% of them occurred in the sub-Saharan Africa region [1]
The efficacy of artemether-lumefantrine for treatment of uncomplicated malaria was still high in the study area the rate of re-infection was high
Summary
Drug resistance to anti-malarials is a major public health problem worldwide. This study aimed at establishing the efficacy of artemether-lumefantrine (ACT) in Igombe-Mwanza, north-western Tanzania after a few years of ACT use, and establish the prevalence of mutations in key targets for artemisinin, chloroquine and sulphadoxine/pyrimetamine (SP) drugs. Even before introduction of AL, re-emergence of wild types for pfcrt has been reported in Malawi with restored sensitivity to CQ [18,19] It is not known whether it is the use of lumefantrine, absence of CQ in the field or both factors acting in synergy that leads to selection of CQ susceptible parasites. Tanzania is a country that has significantly minimized the use of CQ for about 10 years but continues to use SP for IPTp (intermittent presumptive treatment in pregnancy) In such a situation there is a need to continue monitoring the efficacy of AL in endemic areas and prevalence of molecular markers for drug resistance so as to give evidence-based data to national malaria control programmes. This study aimed at establishing the efficacy of AL in Igombe, Mwanza, north-western Tanzania, after a few years of AL use and establish the prevalence of mutations in key targets for artemisinin, chloroquine and sulphadoxine/pyrimetamine (SP) drugs
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