Efficacy and Safety of Artemether-Lumefantrine (Coartem®) for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Ranong and Tak provinces

Abstract

The declining in efficacy of artesunate-mefloquine combination for the treatment of uncomplicated falciparum malaria along the western border of Thailand with Myanmar was less intense than the eastern border with Cambodia. However, the situation had higher impact because of the higher incidence of falciparum malaria patients in the western border. This study aimed at the evaluation of the efficacy and safety of an alternative treatment regimen; a standard 6 doses of a fixed dose combination of artemether-lumefantrine. Acute uncomplicated falciparum malaria patients attending 2 malaria clinics in Ranong province and 3 malaria clinics in Tak province who were fulfilled with the inclusion criteria according to the World Health Organization standard procedure for the efficacy study of antimalarial drug were enrolled into the study. Patients were treated with oral doses of a fixed dose combination of artemether and lumefantrine and were followed up for 42 days. During January to August 2012, 92 patients were enrolled. Of the 79 evaluable patients, 46 and 33 were from Ranong and Tak provinces, respectively. Among the patients completed 28-day follow-up, the adequate clinical and parasitological responses (ACPR) were 93.5% (95%CI = 82.5%-97.8%) in Ranong province and 93.9% (79.3%-98.2%) in Tak province. The ACPR of the 42-day follow-up were 90.9% (95% CI = 78.8%-96.4%) in Ranong province and 93.5% (95% CI = 79.3%-98.2%) in Tak province but there was no statistical different (p>0.05). In conclusion, a 6-doses artemether-lumefantrine in this study was effective and safe for the treatment of acute uncomplicated falciparum malaria. It is able to be an alternative treatment of the acute uncomplicated falciparum malaria in Thailand. However, adherence to the drug should be monitored when the drugs were given to out-patient.