efficacy of artemether/lumefantrine for the treatment of uncomplicated falciparum malaria in children in an area of high transmission in southern Sudan

ABSTRACT

Sudanese health authority adopted a new antimalarial drug policy in response to the reported high level of chloroquine resistance. "Artesunate+ sulfadoxine/pyrimethamine" [ASP] and "artemether/lumefantrine" [A/L] are recommended as first and second lines for the treatment of uncomplicated falciparum malaria respectively. This study aims to evaluate the clinical andparasitological response to A/L and to report any side effects related to the drug in children living in high transmission areas. This evaluation of the clinical and parasitological response to directly observed treatment with 6 doses A/L following WHO protocol for monitoring antimalarial drugs efficacy. Giemsa-stained thick and thin blood smears were examined microscopically on days 0, 2, 3, 7, 14, 21 and 28, or at other times if a patient felt unwell The primary end point was the 28-day cure rate and the secondary end points were time to parasite clearance. A total of 75 [40.8%] patients met the inclusion criteria, of them 70 [97.2%] patients showed adequate clinical and parasitological response [radical cure], 2 [2.8%] patients were classified as early treatment failure and 3 [4%] patients were lost to be followed-up by day 3. No progression to severe illness or danger signs occurred for any patient during the study. The main outcome of study was that A/L was found to be highly effective against Plasmodium falciparum uncomplicated malaria, well tolerated by children with no reported serious side effects. Dramatic decrease in parasites density and fever were observed in most of the cases by day 3 of treatment