Therapeutic Efficacy of Artemether-Lumefantrine (Coartem®) for the Treatment of Uncomplicated Falciparum Malaria in Wondogenet Woreda, Sidama Zone, Ethiopia

Abstract

Introduction: The study was conducted to evaluate therapeutic efficacy of Coartem® for the treatment of uncomplicated falciparum malaria in Wondogenet Woreda, Sidama Zone, Ethiopia. Since the spread of Plasmodium falciparum, parasite resistance to almost all antimalarial monotherapies is a serious impediment to malaria control. Artemether-lumefantrine (Coartem®) therapy has been in use as the first-line treatment for uncomplicated falciparum malaria since 2004 in Ethiopia. Methods: The study was designed according to WHO study protocol. The study outcomes were classified into Early Treatment Failure (ETF), Late Clinical Failure (LCF), Late Parasitological Failure (LPF) and Adequate Clinical and Parasitological Response (ACPR). Results: Primary study was conducted on ninety-nine P. falciparum mono-infected consenting patients who were enrolled in the 28-day in vivo Coartem® treatment followup study. Based on this, the overall cure rate for Coartem® was 98.9% (PCR uncorrected). The study also demonstrated 4.3% Plasmodium vivax and 2.2% P. falciparum/P. vivax co-infections at the end of followup period. Following Coartem® treatment, fever was cleared rapidly on days 1 and 2 and parasite clearance was high on days 1 and 3. Therefore, the study showed a high therapeutic efficacy of Coartem® for the treatment of uncomplicated falciparum malaria in Wondogenet Woreda. Conclusion: Coartem® had high efficacy for the treatment of uncomplicated falciparum malaria. It also had high efficacy with respect to clearance of fever and elimination of gametocytes within short period of time. The tolerability of Coartem® was very good with persistence of only minor adverse effects. The 1.1% LPF detected by the study and the occurrence of P. vivax/P. falciparum co-infection at the end of 28 follow up days require PCR confirmation.