Efficacy of Artemisinin–Lumefantrine for Treatment of Uncomplicated Malaria after More Than a Decade of Its Use in Kenya
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Date
2020
Authors
Kishoyian, Gabriel
Njagi, Eliud N. M.
Orinda, George O.
Kimani, Francis T.
Thiongo, Kevin
Matoke-Muhia, Damaris
Journal Title
Journal ISSN
Volume Title
Publisher
Cambridge University Press
Abstract
Background. The resistance of Plasmodium falciparum to antimalarial drugs remains a major
impairment in the treatment and eradication of malaria globally. Following the introduction
of artemisinin-based combination therapy (ACT), there have been reports of delayed parasite
clearance. In Kenya, artemether–lumefantrine (AL) is the recommended first-line treatment
of uncomplicated malaria. This study sought to assess the efficacy of AL after a decade of
use as the preferred method of managing malarial infections in Kenya. We assessed clinical
and parasitological responses of children under 5 years between May and November 2015
in Chulaimbo sub-County, Kisumu, Kenya. Patients aged between 6 and 60 months with
uncomplicated P. falciparum mono-infection, confirmed through microscopy, were enrolled
in the study. The patients were admitted at the facility for 3 days, treated with a standard
dose of AL, and then put under observation for the next 28 days for the assessment of clinical
and parasitological responses. Of the 90 patients enrolled, 14 were lost to follow-up while 76
were followed through to the end of the study period. Seventy-five patients (98.7%) cleared the
parasitaemia within a period of 48 h while one patient (1.3%) cleared on day 3. There was
100% adequate clinical and parasitological response. All the patients cleared the parasites
on day 3 and there were no re-infections observed during the stated follow-up period. This
study, therefore, concludes that AL is highly efficacious in clearing P. falciparum parasites
in children aged ≥6 and ≤60 months. The study, however, underscores the need for continued
monitoring of the drug to forestall both gradual ineffectiveness and possible resistance to the
drug in all target users.
Description
article
Keywords
Artemether–lumefantrine, efficacy, falciparum malaria, Kenya
Citation
Kishoyian G, Njagi ENM, Orinda GO, Kimani FT, Thiongo K, Matoke- Muhia D (2021). Efficacy of artemisinin– lumefantrine for treatment of uncomplicated malaria after more than a decade of its use in Kenya. Epidemiology and Infection 149, e27, 1–9. https://doi.org/10.1017/ S0950268820003167