Malaria is a major public health problem in Niger. The Global Fund to fight AIDS, Tuberculosis, and Malaria launched, in 2011, an initiative entitled "Affordable Medicines Facility - Malaria" or AMFm which aims to make artemisinin-based combination therapies (ACT) more available, more accessible and to eliminate the development of artemisinin resistance. It is in this context that we have conducted a randomized comparative double open-arm study of the efficacy and safety of artemether-lumefantrine (AL) and artesunate-amodiaquine (AM) in Gaya. The objective of the study is to evaluate and then to compare the efficiency and tolerance to these two combinations. The study was modeled with the WHO 2003, 28 days protocol. 370 febrile patients were examined. 159 patients were included, where 79 (49.4%) were put in the AL arm and 81 (50.6%) were placed in the AM arm. The adequate clinical and parasitological response was 94.8% and 97.1% respectively for AL and AM. There was no statistical significant difference in efficiency between the two therapies . This difference in adverse effects was not statistically significant . Artemether-lumefantrine and artesunate-amodiaquine are two combinations with comparable efficacies and safety.
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Lancet Microbe
December 2024
Malaria Research and Training Centre, Faculty of Pharmacy and Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
Background: Triple artemisinin-based combination therapies (TACTs) can delay the spread of antimalarial drug resistance. Artesunate-amodiaquine is widely used for uncomplicated Plasmodium falciparum malaria. We therefore aimed to determine the safety and efficacy of artemether-lumefantrine-amodiaquine and artesunate-amodiaquine with and without single low-dose primaquine for reducing gametocyte carriage and transmission to mosquitoes.
View Article and Find Full Text PDFLancet Infect Dis
November 2024
Department of Public Health and Community Medicine, Gothenburg University, Gothenburg, Sweden; Research Unit in Rector's Office, Benadir University, Mogadishu, Somalia.
Background: In 2021, nationwide malaria molecular surveillance revealed a high prevalence of a validated artemisinin resistance marker, the kelch13 (k13) Arg561His mutation, in the Kagera region of northwestern Tanzania. We aimed to investigate the efficacy of artemether-lumefantrine and artesunate-amodiaquine and to confirm the presence of artemisinin partial resistance (ART-R) in the Karagwe district of this region.
Methods: This single-arm, therapeutic efficacy study was carried out at the Bukangara dispensary in the Karagwe district of the Kagera region in northwestern Tanzania.
Malar J
April 2024
National Malaria Control Program, Dodoma, Tanzania.
Background: Artemisinin-based combination therapy (ACT) has been a major contributor to the substantial reductions in global malaria morbidity and mortality over the last decade. In Tanzania, artemether-lumefantrine (AL) was introduced as the first-line treatment for uncomplicated Plasmodium falciparum malaria in 2006. The World Health Organization (WHO) recommends regular assessment and monitoring of the efficacy of the first-line treatment, specifically considering that artemisinin resistance has been confirmed in the Greater Mekong sub-region.
View Article and Find Full Text PDFMalar J
April 2024
National Malaria Control Programme (NMCP), P.O. Box 743, Dodoma, Tanzania.
Background: The use of artemisinin-based combination therapy (ACT) is recommended by the World Health Organization for the treatment of uncomplicated falciparum malaria. Artemether-lumefantrine (AL) is the most widely adopted first-line ACT for uncomplicated malaria in sub-Saharan Africa (SSA), including mainland Tanzania, where it was introduced in December 2006. The WHO recommends regular assessment to monitor the efficacy of the first-line treatment specifically considering that artemisinin partial resistance was reported in Greater Mekong sub-region and has been confirmed in East Africa (Rwanda and Uganda).
View Article and Find Full Text PDFMalar J
March 2024
Institut de Recherche Clinique du Benin (IRCB), Cotonou, Benin.
A Stakeholder engagement meeting on the implementation of post-discharge malaria chemoprevention (PDMC) in Benin, Kenya, Malawi, and Uganda was held in Nairobi, Kenya, on 27 September 2023. Representatives from the respective National Malaria Control Programmes, the World Health Organization (WHO) Geneva, Africa Regional and Kenya offices, research partners, non-governmental organizations, and the Medicines for Malaria Venture participated. PDMC was recommended by the WHO in June 2022 and involves provision of a full anti-malarial treatment course at regular intervals during the post-discharge period in children hospitalized with severe anaemia in areas of moderate-to-high malaria transmission.
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