Effectiveness of a 6-dose regimen of Artemether-Lumefantrine for unsupervised treatment of uncomplicated childhood malaria in Calabar, Nigeria

Abstract

Abstract Background: The six dose regimen of Artemether- Lumefantrine (AL), has high efficacy in clinical trials and is the first
-line drug for treating uncomplicated malaria in Nigeria. The complex dosage schedule could militate against its effectiveness.

Objective: To assess the effectiveness of AL prescribed under routine outpatient conditions in the treatment of uncomplicated malaria.

Methods: An open label, noncomparative trial to assess the effectivenessof AL in children 6 to 59 months with uncomplicated P.
falciparum and parasite density between 1,000 and 250,000/μL. Enrolled children received 6-dose course of AL (20/120mg tablets).
The first dose was administered in the health facility and caregivers were instructed on how to administer the remaining five doses at home.
Results: Of the 1035 screened, 215 eligible children were enrolled and 193 completed the study. Twentytwo (22) patients withdrew from the study (18 were lost to follow-up, 3 violated protocol and 1 withdrew consent). Adequate clinical and parasitological response (ACPR) was observed in 90.7%; late clinical failure in 7 (3.6%) and late parasitological failure in 11 (5.7%).

Conclusion: This study showed high efficacy of AL in treating uncomplicated P. falciparum malaria in under-fives in Nigeria. Adherence by caregivers to the treatment regimen was quite good and so, should continue to be used in the home setting.

Keywords: Artemetherlumefantrine, effectiveness, adherence, uncomplicated malaria.