Therapeutic Efficacy of Artemether-Lumefantrine for the Treatment of Uncomplicated P. falciparum Malaria in Alamata District, Tigray, Northern Ethiopia; Five Years After Deployment

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Addis Ababa University


Background: Malaria is one of the most important infectious diseases, causing hundreds of millions of illness and more than one million deaths worldwide annually. The emergence and spread of Plasmodium falciparum resistance to commonly used anti-malarials such as chloroquine and sulfadoxine pyrimethamine has posed major challenges to malaria control in sub Saharan Africa where the problem is most chronic. In response to the anti-malarial drug resistance situations, artemisinin-based combination therapy is the treatment of choice for uncomplicated P. falciparum malaria. In Ethiopia, malaria is a major health problem where climatic factors and altitude play roles to the malaria epidemics and drug resistance aggravates the problem. Objective: The aim of the study was to determine the therapeutic efficacy of ArtemetherLumefantrine against P. falciparum malaria in Alamata District of Tigray Region, North Ethiopia. Methods: During August to November, 2009 a prospective study was conducted on 73 subjects who were above six months of age and fulfilled the inclusion criteria set by WHO. Thick and thin blood smears was employed to determine the presence of parasitemia and parasite density. The standard six-dose regimen of Artemether-lumefantrine was administered over three days and was followed-up with clinical and parasitological evaluations over 28 days. Finally, WHO excel data analysis sheet and SPSS version 15 were used for data entry and analysis. Results: Out of the 73 patients enrolled in the study, 71 were successfully followed and 2 cases were excluded during the 28 days follow up for different reasons. The cure rate was found to be high (97.2 %) in this study. The mean parasite and fever clearance time was 26.5 and 26 respectively. Conclusions and Recommendations: This 97.2% cure rate and /or 2.8% failure rate result is encouraging that the drug could still continue as first-line drug for the treatment of uncomplicated P. falciparum malaria in the study area. However the efficacy of Artemetherlumefantrine needs to be carefully monitored periodically in sentinel sites representing different areas of the region and the country.



Malaria, Plasmodium falciparum, Artemether-lumefantrine, Alamata