THERAPEUTIC EFFICACY OF ARTEMETHER-LUMEFANTRINE FOR THE TREATMENT OF UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA IN BANGLADESH

RASHIDUL HAQUE Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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KAMALA THRIEMER Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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ZHUXI WANG Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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KIMI SATO Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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YUKIKO WAGATSUMA Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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MOHAMMED ABDUS SALAM Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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SELIM AKTHER Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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JASMIN AKTER Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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MARK FUKUDA Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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R. SCOTT MILLER Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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HARALD NOEDL Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria; School of Medicine University of Tsukuba, Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Bangladesh Rural Advancement Committee, Dhaka, Bangladesh; Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Bangladesh faces increasing levels of chloroquine resistance, and drug sensitivity to sulfadoxine-pyremethamine is already compromised. Therefore, the Ministry of Health recently changed the national treatment guidelines to artemisinin-based combination therapies. The purpose of this study was to determine the baseline therapeutic efficacy of artemether-lumefantrine used as a six-dose regimen for the treatment of uncomplicated Plasmodium falciparum malaria. Sixty-seven patients were enrolled in the study; the cure rate in a 42-day follow-up after an adjustment by polymerase chain reaction was 94.3%. The treatment led to rapid fever (mean ± SD = 25.82 ± 12.14 hours) and parasite (30.36 ± 19.43 hours) clearance. These data suggest that artemether-lumefantrine is a highly efficacious and well-tolerated treatment for uncomplicated P. falciparum malaria in Bangladesh.

Author Notes

Reprint requests: Harald Noedl, Department of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria, Telephone: 43-1-4277-64882, Fax: 43-1-4277-64889, E-mail: harald.noedl@meduniwien.ac.at
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