Volume 84, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Chloroquine (CQ) is still the drug of choice for the treatment of vivax malaria in Ethiopia, whereas artemether-lumefantrine (AL) is for falciparum malaria. In this setting, clinical malaria cases are treated with AL. This necessitated the need to assess the effectiveness of AL for the treatment of with CQ as a comparator. A total of 57 (80.3%) and 75 (85.2%) cases treated with CQ or AL, respectively, completed the study in an outpatient setting. At the end of the follow-up period of 28 days, a cumulative incidence of treatment failure of 7.5% (95% confidence interval [CI] = 2.9–18.9%) for CQ and 19% (95% CI = 11–31.6%) for AL was detected. CQ resistance was confirmed in three of five CQ treatment failures cases. The effectiveness of AL seems lower than CQ; however, the findings were not conclusive, because the AL evening doses were not supervised.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Ghebreyesus T, Deressa W, Berhane Y, Hailemariam D, Kloos H, , 2006. Malaria. , eds. Epidemiology and Ecology of Health and Disease in Ethiopia. Addis Ababa, Ethiopia: Shama Books, 556576. [Google Scholar]
  2. Federal Ministry of Health of Ethiopia, 2001. National Strategic Plan for Malaria Prevention and Control in Ethiopia 2001–2005. Available at: http://www.moh.gov.et/index.php. Accessed May 15, 2009. [Google Scholar]
  3. Federal Ministry of Health of Ethiopia, 2004. Malaria Diagnosis and Treatment Guidelines for Health Workers in Ethiopia, 2nd ed. Available at: http://www.moh.gov.et/index.php. Accessed May 15, 2009. [Google Scholar]
  4. Daddi J, Gezahegn T, Ambachew M, Asnakew K, Daniel A, Olusegun B, , 2005. Therapeutic efficacy of sulfadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in Ethiopia. East Afr Med J 82: 391395. [Google Scholar]
  5. Teklehaimanot A, , 1996. Chloroquine-resistant Plasmodium falciparum malaria in Ethiopia. Lancet 328: 127129.[Crossref] [Google Scholar]
  6. World Health Organization, 2002. Report of WHO Consultation on Monitoring Antimalarial Drug Resistance, WHO/CDS/CSR/EPH/2002.17 and WHO/CDS/RBM/2002.39. Geneva, Switzerland: World Health Organization. [Google Scholar]
  7. Imwong M, Pukrittayakamee S, Grüner AC, Rénia L, Letourneur F, Looareesuwan S, White NJ, Snounou G, , 2005. Practical PCR genotyping protocols for Plasmodium vivax using Pvcs and Pvmsp. Malar J 4: 20.[Crossref] [Google Scholar]
  8. Lindegardh N, Forslund M, Green MD, Kaneko A, Bergqvist Y, , 2002. Automated solid-phase extraction for determination of amodiaquine, chloroquine and metabolites in capillary blood on sampling paper by liquid chromatography. Chromatographia 55: 512.[Crossref] [Google Scholar]
  9. Baird JK, Leksana B, Masbar S, Fryauff DJ, Sutanihardja MA, Suradi Wignall FS, Hoffman SL, , 1997. Diagnosis of resistance to chloroquine by Plasmodium vivax: timing of recurrence and whole blood chloroquine levels. Am J Trop Med Hyg 56: 621626. [Google Scholar]
  10. Tulu A, Webber H, Schellenberg A, Bradley D, , 1996. Failure of chloroquine treatment for malaria in the highlands of Ethiopia. Trans R Soc Trop Med Hyg 90: 556557.[Crossref] [Google Scholar]
  11. Yeshiwondim A, Tekle A, Dengela D, Yohannes A, Teklehaimanot A, , 2009. Therapeutic Efficacy of Chloroquine and Chloroquine Plus Primaquine for the Treatment of Plasmodium vivax in Ethiopia. Available at: http://www.sciencedirect.com/science/journal/0001706X. Accessed October 14, 2009. [Google Scholar]
  12. Baird J, Sustriayu N, Basri H, Masbar S, Leksana B, Tjitra E, Dewi R, Khairani M, Wignall F, , 1996. Survey of resistance to chloroquine by Plasmodium vivax in Indonesia. Trans R Soc Trop Med Hyg 90: 409411.[Crossref] [Google Scholar]
  13. Biard J, , 2004. Minireview: chloroquine resistance in Plasmodium vivax . Antimicrob Agents Chemother 48: 40754083.[Crossref] [Google Scholar]
  14. Teka H, Petros B, Yamuah Y, Tesfaye G, Ibrahim Elhassan I, Simon Muchohi S, Kokwaro G, Aseffa A, Engers H, , 2008. Chloroquine-resistant Plasmodium vivax malaria in Debre Zeit, Ethiopia. Malar J 7: 220.[Crossref] [Google Scholar]
  15. Ketema T, Bacha K, Birhanu T, Petros P, , 2009. Chloroquine-resistant Plasmodium vivax malaria in Serbo town, Jimma zone, South-West Ethiopia. Malar J 8: 177.[Crossref] [Google Scholar]
  16. Baird J, Lacy M, Basri H, Barcus M, Maguire J, Bangs M, Gramzinski R, Sismadi P, Krisin Ling J, Wiady I, Kusumaningsih M, Jones TR, Fryauff D, Hoffman S, , 2001. Randomized, parallel placebo-controlled trail of primaquine for malaria prophylaxis in Papua, Indonesia. Clin Infect Dis 33: 19901997.[Crossref] [Google Scholar]
  17. Imwong M, Snounou G, Pukrittayakamee S, Tanomsing N, Kim J, Nandy A, Guthmann J, Nosten F, Carlton J, Looareesuwan S, Nair S, Sudimack D, Day N, Anderson T, White N, , 2007. Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites. J Infect Dis 195: 927933.[Crossref] [Google Scholar]
  18. Chen N, Auliff A, Rieckmann K, Gatton M, Cheng Q, , 2007. Relapses of Plasmodium vivax infection result from clonal hypnozoites activated at predetermined intervals. J Infect Dis 195: 934941.[Crossref] [Google Scholar]
  19. Daddi J, Gezahegn T, Ambachew M, Asnakew K, Daniel A, Olusegun B, , 2005. Baseline study on the safety and efficacy artemether-lumefantrine in the treatment of uncomplicated falciparum malaria in Ethiopia. East Afr Med J 82: 387390. [Google Scholar]
  20. Piola P, Fogg C, Bajunirwe F, Biraro S, Grandesso F, Ruzagira E, Babigumira J, Kigozi I, Kiguli J, Kyomuhendo J, Ferradini L, Taylor W, Checchi F, Guthmann J, , 2005. Supervised versus unsupervised intake of six-dose artemether-lumefantrine for treatment of acute, uncomplicated Plasmodium falciparum malaria in Mbarara, Uganda: a randomised trial. Lancet 365: 14671473.[Crossref] [Google Scholar]
  21. Krudsood S, Tangpukdee N, Muangnoicharoen S, Thanachartwet V, Luplertlop N, Srivilairit S, Wilairatana P, Kano S, Ringwald P, Looareesuwan S, , 2007. Clinical efficacy of chloroquine versus artemether-lumefantrine for Plasmodium vivax treatment in Thailand. Korean J Parasitol 45: 111114.[Crossref] [Google Scholar]
  22. Karunajeewa H, Mueller I, Senn M, Lin E, Law I, Gomorrai S, Oa O, Griffin S, Kotab K, Suano P, Tarongka N, Ura A, Lautu D, Page-Sharp M, Wong R, Salman S, Siba P, Ilett K, Davis T, , 2008. A trial of combination antimalarial therapies in children from Papua New Guinea. N Engl J Med 359: 25452557.[Crossref] [Google Scholar]
  23. Ratcliff A, Siswantoro H, Kenangalem E, Maristela R, Wuwung R, Laihad F, Ebsworth E, Anstey N, Tjitra N, Price R, , 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]
  24. Baird K, Basri H, Subuanto B, Fryauff J, McElroy D, Leksana B, Richie TL, Masbar S, Wignall FS, Hoffman SL, , 1995. Treatment of chloroquine-resistant Plasmodium vivax with chloroquine and primaquine or halofantrine. J Infect Dis 171: 678682.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 04 Dec 2009
  • Accepted : 04 Aug 2010
  • Published online : 05 Jan 2011

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