Nutritional Advice El Mondo
Objectives:
As Ethiopia is one of the sub-Saharan countries with a great burden of malaria the effectiveness of first line anti-malarial drugs is the major concern. Therefore, this review article (meta-analysis) has been conducted.
What is the efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia?
Study design:
This review article included 10 prospective single-arm cohort studies involving 1,179 patients with a mean age of 15.8 years.
In the majority (80%) of the studies, subjects were followed for 28 days, while in the remaining (20%) studies; the follow-up period was 42 days.
In each study, anywhere from 66 to 384 patients with P. falciparum mono-infection were included.
Most (70%) of the studies followed patients who were older than six months.
All of the included studies were deemed to be of high quality.
Heterogeneity between the studies was minimal (I2 = 38.8%).
At recruitment, the average parasite count per patient was 12,981/μL of blood and gametocytes were found in 7.7% of patients.
The mean temperature of patients on the day of enrolment was 38.2 ± 0.35 °C.
Results and conclusions:
The investigators found on the third day of treatment, 96.7% and 98.5% of study subjects become fever-free and parasite-free, respectively.
The investigators also found a significant decrease in gametocyte carriage from 7.7% at baseline to 0.4% on the 28th day of treatment.
The investigators found based on the per protocol analysis, the cure rate after use of artemether-lumefantrine was 98.2% (polymerase chain reaction corrected) and 97.01% (polymerase chain reaction uncorrected) after 28 days of follow-up. The reinfection rate within 28 days was 1.1% and the recrudescence rate was 1.9%.
The investigators concluded that the cure rate for uncomplicated P. falciparum malaria using artemether-lumefantrine in Ethiopia is still high enough to recommend the drug as a first-line agent. There should be careful periodic monitoring of the efficacy of this drug, as treatment failure may occur due to resistance, sub-therapeutic levels that may occur due to non-adherence or inadequate absorption.
Original title:
Therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia: a systematic review and meta-analysis by Ayalew MB.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686809/
Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.