| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Artemether-lumefantrine is the first registered, fixed, artemisinin-based combination treatment. Artemisinin derivatives are highly effective antimalarials with a favorable safety profile. Concerns remain over their potential neurotoxicity, although there has been no clinical evidence of this in humans. In animals (rats, dogs, and monkeys) artemether, a derivative of artemisinin is associated with an unusual toxicity pattern in specific brain nuclei involving the auditory and vestibular pathways. A recent report from Mozambique described a small but significant and irreversible hearing loss in patients exposed to artemether-lumefantrine. To explore this issue, we conducted a case-control study using tympanometry, audiometry and auditory brain-stem responses. We assessed 68 subjects who had been treated with artemether-lumefantrine within the previous five years and 68 age- and sex-matched controls living in the malarious region along the Thailand-Myanmar border. There were no differences in the test results between cases and controls. There was no neurophysiologic evidence of auditory brainstem toxicity that could be attributed to artemether-lumefantrine in this study population.
Received August 8, 2005. Accepted for publication October 6, 2005.
Acknowledgments: We thank the volunteers who participated to the study and the staff of the Shoklo Malaria Research Unit for technical assistance. We also acknowledge the precious comments of Professor Ed Mansell on the manuscript.
Financial support: This investigation was part of the Wellcome Trust Mahidol University Oxford Tropical Medicine Research Programme supported by the Wellcome Trust of Great Britain.
* Address correspondence to François Nosten, Shoklo Malaria Research Unit. 68/30 Baan Toong Road, P.O. Box 46, Mae Sot 63110, Thailand. E-mail: smru{at}tropmedres.ac
Authors’ addresses: Robert Hutagalung, Hsar Htoo, Paw Nwee, Jaruwan Arunkamomkiri, Julien Zwang, and Verena I. Carrara, Shoklo Malaria Research Unit, 68/30 Baan Toong Road, P.O. Box 46, Mae Sot 63110, Thailand. Elizabeth Ashley, Shoklo Malaria Research Unit, 68/30 Baan Toong Road, P.O. Box 46, Mae Sot 63110, Thailand and Centre for Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, OX3 7LJ, United Kingdom. Pratap Singhasivanon, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Bangkok 10400, Thailand. Nicholas J. White, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Bangkok 10400, Thailand and Centre for Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, OX3 7LJ, United Kingdom. François Nosten, Shoklo Malaria Research Unit, 68/30 Baan Toong Road, P.O. Box 46, Mae Sot 63110, Thailand, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Bangkok 10400, Thailand, and Centre for Vaccinology and Tropical Medicine, Churchill Hospital , Oxford, OX3 7LJ, United Kingdom , E-mail : smru{at}tropmedres.ac.
This article has been cited by other articles:
|
|
 |
|
  P. J. Rosenthal Artesunate for the Treatment of Severe Falciparum Malaria N. Engl. J. Med., April 24, 2008; 358(17): 1829 - 1836. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Nosten and N. J. White Artemisinin-Based Combination Treatment of Falciparum Malaria Am J Trop Med Hyg, December 1, 2007; 77(6_Suppl): 181 - 192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. RAMHARTER, D. BURKHARDT, J. NEMETH, A. A. ADEGNIKA, and P. G. KREMSNER IN VITRO ACTIVITY OF ARTEMISONE COMPARED WITH ARTESUNATE AGAINST PLASMODIUM FALCIPARUM. Am J Trop Med Hyg, October 1, 2006; 75(4): 637 - 639. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Toovey A CASE-CONTROL AUDITORY EVALUATION OF PATIENTS TREATED WITH ARTEMETHER-LUMEFANTRINE Am J Trop Med Hyg, June 1, 2006; 74(6): 939 - 940. [Full Text] [PDF]
|
|
|
|
|
|
F. Nosten, R. Hutagalung, V. I. Carrara, E. Ashley, and N. White LETTERS TO THE EDITOR Am J Trop Med Hyg, June 1, 2006; 74(6): 940 - 940. [Full Text] [PDF]
|
|
|
|
|
|
M. MAKANGA, Z. PREMJI, C. FALADE, J. KARBWANG, E. A. MUELLER, K. ANDRIANO, P. HUNT, and P. I. DE PALACIOS EFFICACY AND SAFETY OF THE SIX-DOSE REGIMEN OF ARTEMETHER-LUMEFANTRINE IN PEDIATRICS WITH UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA: A POOLED ANALYSIS OF INDIVIDUAL PATIENT DATA Am J Trop Med Hyg, June 1, 2006; 74(6): 991 - 998. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
