Volume 86, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



This study was conducted to correlate blood concentrations of lumefantrine with treatment outcome for patients with malaria when the drug was given without specific instructions for administration with food. Patients with malaria in the highly endemic state of Orissa, India, were enrolled during 2008 and followed-up for 28 days after admistration of artemether-lumefantrine for three days according to a World Health Organization protocol. Drug concentration in whole blood was determined by using blood spots placed on filter paper on day 7. The technology is suitable for field studies. One hundred percent of the patients had an adequate clinical and parasitological response. These results confirm the efficacy of artemether-lumefantrine in persons from poor tribal communities when given without specific instructions regarding co-administration with food, despite high inter-individual variability in blood concentrations of lumefantrine.


Article metrics loading...

Loading full text...

Full text loading...



  1. Manyando C, Mkandawire R, Puma L, Sinkala M, Mpabalwani E, Njunju E, Gomes M, Ribeiro I, Walter V, Virtanen M, Schlienger R, Cousin M, Chipimo M, Sullivan FM, , 2010. Safety of artemether-lumefantrine in pregnant women with malaria: results of a prospective cohort study in Zambia. Malar J 9: 249.[Crossref]
  2. Kshirsagar NA, Gogtay NJ, Moorthy NS, Garg MR, Dalvi SS, Chogle AR, Sorabjee JS, Marathe SN, Tilve GH, Bhatt AD, Sane SP, Mull R, Gathmann I, , 2000. A randomized, double blind, parallel group, comparative safety, and efficacy trial of co-artemether versus oral chloroquine in the treatment of acute uncomplicated Plasmodium falciparum malaria in adults in India. Am J Trop Med Hyg 62: 402408.
  3. Valecha N, Srivastava P, Mohanty SS, Mittra P, Sharma SK, Tyagi PK, Pradhan K, Dev V, Singh R, Dash AP, Sharma YD, , 2009. Therapeutic efficacy of artemether-lumefantrine in uncomplicated falciparum malaria in India. Malar J 19: 107.
  4. World Health Organization, 2010. Guidelines for the Treatment of Malaria. Second edition. Available at: http://www.who.int/malaria/publications/atoz/9789241547925/en/index.html.
  5. White NJ, Van MV, Ezzet F, , 1999. Clinical pharmacokinetics and pharmacodynamics of artemether-lumefantrine. Clin Pharmacokinet 37: 105125.[Crossref]
  6. Blessborn D, Romsing S, Annerberg A, Sundquist D, Bjorkman A, Lindegardh N, Bergquist Y, , 2007. Development and validation of an automated solid-phase extraction and liquid chromatographic method for determination of lumefantrine in capillary blood on sampling paper. J Pharm Biomed Anal 45: 82287.[Crossref]
  7. World Health Organization, 2003. Assessment and Monitoring of Antimalarial Drug Efficacy for the Treatment of Uncomplicated falciparum Malaria. Available at: http://www.who.int/malaria/publications/atoz/9789241547925/en/index.html.
  8. Ezzet F, Vugt MV, Nosten F, Looareesuwan S, White NJ, , 2000. Pharmacokinetics and pharmacodynamics of lumefantrine (Benflumetol) in acute falciparum malaria. Antimicrob Agents Chemother 45: 697704.
  9. Price RN, Uhlemann AC, Van VM, Brockman A, Hutagalung R, Nair S, Nash D, Singhasivanon P, Anderson TJ, Krishna S, White NJ, Nosten F, , 2006. Molecular and pharmacological determinants of the therapeutic response to artemether-lumefantrine in multidrug-resistant Plasmodium falciparum malaria. Clin Infect Dis 42: 15701577.[Crossref]
  10. Denis MB, Tsuyuoka R, Lim P, Lindegardh N, Yi P, Top SN, Socheat D, Fandeur T, Annerberg A, Christophel EM, Ringwald P, , 2006. Efficacy of artemether-lumefantrine for the treatment of uncomplicated falciparum malaria in northwest Cambodia. Trop Med Int Health 11: 18001807.[Crossref]
  11. Ashley EA, Stepniewska K, Lindegardh N, Annerberg AK, Brockman AL, Singhasivanon P, White NJ, Nosten F, , 2007. How much fat is necessary to optimize lumefantrine oral bioavailability? Trop Med Int Health 12: 195200.[Crossref]
  12. 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 JP, , 2005. Supervised versus unsupervised intake of six-dose artemether-lumefantrine for treatment of acute, uncomplicated Plasmodium falciparum malaria in Mbarara, Uganda: a randomized trial. Lancet 365: 14671473.[Crossref]
  13. Mutabingwa T, Anthony D, Heller A, Hallett R, Ahmed J, Drakeley C, Greenwood BM, Whitty CJ, , 2005. Amodiaquine alone, amodiaquine + sulfadoxine-pyrimethamine, amodiaquine + artesunate, and artemether-lumefantrine for outpatient treatment of malaria in Tanzanian children: a four-arm randomised effectiveness trial. Lancet 365: 14741480.[Crossref]
  14. Premji ZG, Abdulla S, Ogutu B, Ndong A, Falade CO, Sagara I, Mulure N, Nwaiwu O, Kokwaro G, , 2008. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence. Malar J 25: 244.
  15. Nigam A, , 2000. Consumption of fat in Indian diet. Int J Diab Dev Countries 20: 5861.

Data & Media loading...

  • Received : 28 Mar 2011
  • Accepted : 13 Sep 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