dc.contributor.author | Kamya, Moses.R | |
dc.contributor.author | Yeka, Adoke | |
dc.contributor.author | Bukirwa, Hasifa | |
dc.contributor.author | Lugemwa, Myers | |
dc.contributor.author | Rwakimari, John B. | |
dc.contributor.author | Staedke, Sarah G. | |
dc.contributor.author | Talisuna, Ambrose O. | |
dc.contributor.author | Greenhouse, Bryan | |
dc.contributor.author | Nosten, Francois | |
dc.contributor.author | Rosenthal, Philip J. | |
dc.contributor.author | Wabwire-Mangen, Fred | |
dc.contributor.author | Dorsey, Grant | |
dc.date.accessioned | 2012-02-02T15:19:44Z | |
dc.date.available | 2012-02-02T15:19:44Z | |
dc.date.issued | 2007-05-18 | |
dc.identifier.citation | Kamya, M.R., Yeka, A., Bukirwa, H., Lugemwa, M., Rwakimari, J.B., Staedke, S.G., Talisuna, A.O., Greenhouse, B., Nosten, F., Rosenthal, P.J., Wabwire-Mangen, F., Dorsey, G. (2007). Artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment of malaria: a randomized trial. PLoS Clinical Trials, 2(5) | en_US |
dc.identifier.issn | 1555-5887 | |
dc.identifier.uri | doi:10. 1371/journal.pctr.0020020 | |
dc.identifier.uri | http://hdl.handle.net/10570/377 | |
dc.description.abstract | Objectives: To compare the efficacy and safety of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) for treating uncomplicated falciparum malaria in Uganda. Design: Randomized single-blinded clinical trial. Setting: Apac, Uganda, an area of very high malaria transmission intensity. Participants: Children aged 6 mo to 10 y with uncomplicated falciparum malaria. Intervention: Treatment of malaria with AL or DP, each following standard 3-d dosing regimens. Outcome measures: Risks of recurrent parasitemia at 28 and 42 d, unadjusted and adjusted by genotyping to distinguish recrudescences and new infections. Results: Of 421 enrolled participants, 417 (99%) completed follow-up. The unadjusted risk of recurrent falciparum parasitemia was significantly lower for participants treated with DP than for those treated with AL after 28 d (11% versus 29%; risk difference [RD] 18%, 95% confidence interval [CI] 11%–26%) and 42 d (43% versus 53%; RD 9.6%, 95% CI 0%–19%) of follow-up. Similarly, the risk of recurrent parasitemia due to possible recrudescence (adjusted by genotyping) was significantly lower for participants treated with DP than for those treated with AL after 28 d (1.9% versus 8.9%; RD 7.0%, 95% CI 2.5%–12%) and 42 d (6.9% versus 16%; RD 9.5%, 95% CI 2.8%–16%). Patients treated with DP had a lower risk of recurrent parasitemia due to non-falciparum species, development of gametocytemia, and higher mean increase in hemoglobin compared to patients treated with AL. Both drugs were well tolerated; serious adverse events were uncommon and unrelated to study drugs. Conclusion: DP was superior to AL for reducing the risk of recurrent parasitemia and gametocytemia, and provided improved hemoglobin recovery. DP thus appears to be a good alternative to AL as first-line treatment of uncomplicated malaria in Uganda. To maximize the benefit of artemisinin-based combination therapy in Africa, treatment should be integrated with aggressive strategies to reduce malaria transmission intensity. | en_US |
dc.description.sponsorship | This investigation received financial support from the US Centers for Disease Control under Cooperative Agreement Number U50/CCU925122–01 and, from Malaria Consortium Drugman, SUBK0001 with support from the Department for International
Development (DFID). Dihydroartemisinin-piperaquine study drugs were provided free of charge by Holleypharm, China. | en_US |
dc.language.iso | en | en_US |
dc.subject | Malaria | en_US |
dc.subject | Uganda | en_US |
dc.subject | Artemisinin-based compound therapy (ACT) | en_US |
dc.subject | Children | en_US |
dc.subject | Malaria recurrence | en_US |
dc.title | Artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment of malaria: a randomized trial. | en_US |
dc.type | Journal article, peer reviewed | en_US |