Efficacy of artemether-lumefantrine and artesunate-amodiaquine as first line therapy of uncomplicated malaria in Burkina Faso, 11 years after policy change

Pan Afr Med J. 2020 Mar 10:35:68. doi: 10.11604/pamj.2020.35.68.20849. eCollection 2020.

Abstract

Introduction: Artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) are the first line therapy of uncomplicated malaria in Burkina Faso. We assessed the treatment efficacy, tolerability of these drugs 11 years following its adoption as first line treatment.

Methods: In this opened randomized controlled trial carried out in 2016, participants with age over 6 months who consented to participate were randomly assigned treatment with artemether-lumefantrine or artesunate-amodiaquine and followed up for 28 days. Primary endpoint was the treatment efficacy over 28 days of follow up unadjusted by Polymerase chain reaction (PCR).

Results: Two hundred and eighty-one (281) participants were enrolled and the completion rate was 92.9%. No early treatment failure was found. Adequate clinical and parasitological responses were significantly higher in artesunate-amodiaquine group (97% versus 85.2%, p = 0.0008). On day 28, the risk of failure was 4 times higher in AL group 20.14%, 95% CI (13-30.47) against 5.16%, 95% CI (1.91-13.54) in ASAQ group. All treatments had a similar and good tolerability profile.

Conclusion: Eleven years following artemether-lumefantrine and artesunate-amodiaquine adoption as first line therapy for uncomplicated malaria in Burkina Faso, artemether-lumefantrine retained fairly good efficacy even though its efficacy fell below WHO threshold of 90% considering uncorrected outcome.

Keywords: Burkina Faso; first line ACTs efficacy; malaria.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Amodiaquine / administration & dosage*
  • Amodiaquine / adverse effects
  • Antimalarials / administration & dosage*
  • Antimalarials / adverse effects
  • Artemether, Lumefantrine Drug Combination / administration & dosage*
  • Artemether, Lumefantrine Drug Combination / adverse effects
  • Artemisinins / administration & dosage*
  • Artemisinins / adverse effects
  • Burkina Faso
  • Child
  • Child, Preschool
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Malaria / drug therapy*
  • Male
  • Polymerase Chain Reaction
  • Treatment Failure
  • Treatment Outcome

Substances

  • Antimalarials
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins
  • Drug Combinations
  • amodiaquine, artesunate drug combination
  • Amodiaquine