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Therapeutic Efficacies of Artemisinin-Based Combination Therapies in Nigerian Children with Uncomplicated Falciparum Malaria during Five Years of Adoption as First-Line Treatments

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  • Department of Pharmacology and Therapeutics and Institute for Medical Research and Training, University of Ibadan, Ibadan, Nigeria
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The therapeutic efficacies of 3-day regimens of artesunate-amodiaquine and artemether-lumefantrine during 5 years of adoption as first-line treatments were evaluated in 811 ≤ 12-year-old malarious children. Compared with artemether-lumefantrine, amodiaquine-artesunate significantly reduced the proportion of children with fever and parasitemia 1 day after treatment (day 1; P < 0.008 for both). The proportion of parasitemic children on day 2 and gametocytemia on presentation and carriage reduced significantly over the years (P < 0.000001 and P < 0.03, respectively; test for trend). Overall efficacy was 96.5% (95% confidence interval [CI] = 94.5–98.6) and remained unchanged over the years (P = 0.87; test for trend). Kinetics of parasitemias after treatments were estimated by a non-compartmental model. Declines of parasitemias were monoexponential, with a mean elimination half-life of 1.09 hours (95% CI = 1.0–1.16). Parasitemia half-lives and efficacy were similar for both regimens and in all ages. Artesunate-amodiaquine and artemether-lumefantrine remain efficacious treatments of uncomplicated falciparum malaria in Nigerian children 5 years after adoption.

Author Notes

*Address correspondence to Akintunde Sowunmi, Department of Clinical Pharmacology, University College Hospital, Queen Elizabeth Road, Ibadan, Oyo state, Nigeria, 2053. E-mail: akinsowunmi@hotmail.com

Authors' address: Grace O. Gbotosho, Akintunde Sowunmi, Christian T. Happi, and Titilope M. Okuboyejo, Department of Pharmacology and Therapeutics and Institute for Medical Research and Training, University of Ibadan, Nigeria, E-mails: solagbotosho@yahoo.co.uk, akinsowunmi@hotmail.com, christianhappi@hotmail.com, and attitte@yahoo.com.

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