Artemether-Lumefantrine versus Dihydroartemisinin-Piperaquine for Treatment of Malaria: A Randomized Trial

• DOI: 10.1371/journal.pctr.0020020
• Publication Date: 2007-05-15T11:46:34Z
• Authors: Moses R Kamya; Adoke Yeka; Hasifa Bukirwa; Myers Lugemwa; John B Rwakimari; Sarah G Staedke; Ambrose O Talisuna; Bryan Greenhouse; François Nosten; Philip J Rosenthal; Fred Wabwire-Mangen; Grant Dorsey
• Keywords: Artemether/lumefantrine; Artemether; Dihydroartemisinin; Artesunate

To compare the efficacy and safety of artemether-lumefantrine (AL) dihydroartemisinin-piperaquine (DP) for treating uncomplicated falciparum malaria in Uganda.Randomized single-blinded clinical trial.Apac, Uganda, an area very high transmission intensity.Children aged 6 mo to 10 y with malaria.Treatment AL or DP, each following standard 3-d dosing regimens.Risks recurrent parasitemia at 28 42 d, unadjusted adjusted by genotyping distinguish recrudescences new infections.Of 421 enrolled participants, 417 (99%) completed follow-up. The risk was significantly lower participants treated DP than those after d (11% versus 29%; difference [RD] 18%, 95% confidence interval [CI] 11%-26%) (43% 53%; RD 9.6%, CI 0%-19%) Similarly, due possible recrudescence (adjusted genotyping) (1.9% 8.9%; 7.0%, 2.5%-12%) (6.9% 16%; 9.5%, 2.8%-16%). Patients had a non-falciparum species, development gametocytemia, higher mean increase hemoglobin compared patients AL. Both drugs were well tolerated; serious adverse events uncommon unrelated study drugs.DP superior reducing provided improved recovery. thus appears be good alternative as first-line treatment Uganda. maximize benefit artemisinin-based combination therapy Africa, should integrated aggressive strategies reduce intensity.