1921
Volume 83, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) are highly efficacious antimalarial therapies in Africa. However, there are limited data regarding the tolerability of these drugs in young children. We used data from a randomized control trial in rural Uganda to compare the risk of early vomiting (within one hour of dosing) for children 6–24 months of age randomized to receive DP (n = 240) or AL (n = 228) for treatment of uncomplicated malaria. Overall, DP was associated with a higher risk of early vomiting than AL (15.1% versus 7.1%; = 0.007). The increased risk of early vomiting with DP was only present among breastfeeding children (relative risk [RR] = 3.35, = 0.001) compared with children who were not breastfeeding (RR = 1.03, = 0.94). Age less than 18 months was a risk factor for early vomiting independent of treatment (RR = 3.27, = 0.02). Our findings indicate that AL may be better tolerated than DP among young breastfeeding children treated for uncomplicated malaria.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.2010.10-0158
2010-10-05
2018-12-13
Loading full text...

Full text loading...

/deliver/fulltext/14761645/83/4/873.html?itemId=/content/journals/10.4269/ajtmh.2010.10-0158&mimeType=html&fmt=ahah

References

  1. Nosten F, White NJ, , 2007. Artemisinin-based combination treatment of falciparum malaria. Am J Trop Med Hyg 77: 181192. [Google Scholar]
  2. Olliaro P, Wells TN, , 2009. The global portfolio of new antimalarial medicines under development. Clin Pharmacol Ther 85: 584595.[Crossref] [Google Scholar]
  3. Arinaitwe E, Sandison TG, Wanzira H, Kakuru A, Homsy J, Kalamya J, Kamya MR, Vora N, Greenhouse B, Rosenthal PJ, Tappero J, Dorsey G, , 2009. Artemether-lumefantrine versus dihydroartemisinin-piperaquine for falciparum malaria: a longitudinal, randomized trial in young Ugandan children. Clin Infect Dis 49: 16291637.[Crossref] [Google Scholar]
  4. Ratcliff A, Siswantoro H, Kenangalem E, Maristela R, Wuwung RM, Laihad F, Ebsworth EP, Anstey NM, Tjitra E, Price RN, , 2007. Two fixed-dose artemisinin combinations for drug-resistant falciparum and vivax malaria in Papua, Indonesia: an open-label randomised comparison. Lancet 369: 757765.[Crossref] [Google Scholar]
  5. Yeka A, Dorsey G, Kamya MR, Talisuna A, Lugemwa M, Rwakimari JB, Staedke SG, Rosenthal PJ, Wabwire-Mangen F, Bukirwa H, , 2008. Artemether-lumefantrine versus dihydroartemisinin-piperaquine for treating uncomplicated malaria: a randomized trial to guide policy in Uganda. PLoS ONE 3: e2390.[Crossref] [Google Scholar]
  6. Zwang J, Ashley EA, Karema C, D'Alessandro U, Smithuis F, Dorsey G, Janssens B, Mayxay M, Newton P, Singhasivanon P, Stepniewska K, White NJ, Nosten F, , 2009. Safety and efficacy of dihydroartemisinin-piperaquine in falciparum malaria: a prospective multi-centre individual patient data analysis. PLoS ONE 4: e6358.[Crossref] [Google Scholar]
  7. Leonardi E, Gilvary G, White NJ, Nosten F, , 2001. Severe allergic reactions to oral artesunate: a report of two cases. Trans R Soc Trop Med Hyg 95: 182183.[Crossref] [Google Scholar]
  8. ter Kuile FO, Nosten F, Luxemburger C, Kyle D, Teja-Isavatharm P, Phaipun L, Price R, Chongsuphajaisiddhi T, White NJ, , 1995. Mefloquine treatment of acute falciparum malaria: a prospective study of non-serious adverse effects in 3673 patients. Bull World Health Organ 73: 631642. [Google Scholar]
  9. Bukirwa H, Nayiga S, Lubanga R, Mwebaza N, Chandler C, Hopkins H, Talisuna AO, Staedke SG, , 2008. Pharmacovigilance of antimalarial treatment in Uganda: community perceptions and suggestions for reporting adverse events. Trop Med Int Health 13: 11431152.[Crossref] [Google Scholar]
  10. Price RN, Dorsey G, Nosten F, , 2009. Antimalarial therapies in children from Papua New Guinea. N Engl J Med 360: 1254, author reply 1255.[Crossref] [Google Scholar]
  11. Sim IK, Davis TM, Ilett KF, , 2005. Effects of a high-fat meal on the relative oral bioavailability of piperaquine. Antimicrob Agents Chemother 49: 24072411.[Crossref] [Google Scholar]
  12. Borrmann S, Sallas WM, Machevo S, Gonzalez R, Bjorkman A, Martensson A, Hamel M, Juma E, Peshu J, Ogutu B, Djimde A, D'Alessandro U, Marrast AC, Lefevre G, Kern SE, , 2010. The effect of food consumption on lumefantrine bioavailability in African children receiving artemether-lumefantrine crushed or dispersible tablets (Coartem) for acute uncomplicated Plasmodium falciparum malaria. Trop Med Int Health 15: 434441. [Google Scholar]
  13. ter Kuile FO, Luxemburger C, Nosten F, Thwai KL, Chongsuphajaisiddhi T, White NJ, , 1995. Predictors of mefloquine treatment failure: a prospective study of 1590 patients with uncomplicated falciparum malaria. Trans R Soc Trop Med Hyg 89: 660664.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2010.10-0158
Loading
/content/journals/10.4269/ajtmh.2010.10-0158
Loading

Data & Media loading...

  • Received : 13 Mar 2010
  • Accepted : 20 Jul 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error