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    Artemether-lumefantrine versus artemisinin-naphthoquine in Papua New Guinean children with uncomplicated malaria: A six months post-treatment follow-up study

    246402_246402.pdf (488.5Kb)
    Access Status
    Open access
    Authors
    Laman, M.
    Benjamin, J.
    Moore, Brioni
    Salib, M.
    Tawat, S.
    Davis, W.
    Siba, P.
    Robinson, L.
    Davis, T.
    Date
    2015
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Laman, M. and Benjamin, J. and Moore, B. and Salib, M. and Tawat, S. and Davis, W. and Siba, P. et al. 2015. Artemether-lumefantrine versus artemisinin-naphthoquine in Papua New Guinean children with uncomplicated malaria: A six months post-treatment follow-up study. Malaria Journal. 14 (1).
    Source Title
    Malaria Journal
    DOI
    10.1186/s12936-015-0624-4
    Faculty
    Faculty of Health Sciences
    School
    School of Pharmacy
    Remarks

    This open access article is distributed under the Creative Commons license https://creativecommons.org/licenses/by/4.0/

    URI
    http://hdl.handle.net/20.500.11937/33377
    Collection
    • Curtin Research Publications
    Abstract

    Background: In a recent trial of artemisinin-naphthoquine (artemisinin-NQ) and artemether-lumefantrine (AM-LM) therapy in young children from Papua New Guinea (PNG), there were no treatment failures in artemisinin-NQ-treated children with Plasmodium falciparum or Plasmodium vivax compared with 2.2% and 30.0%, respectively, in AM-LM-treated children during 42 days of follow-up. To determine whether, consistent with the long elimination half-life of NQ, this difference in efficacy would be more durable, clinical episodes of malaria were assessed in a subset of trial patients followed for six months post-treatment. Methods: For children completing trial procedures and who were assessable at six months, all within-trial and subsequent clinical malaria episodes were ascertained, the latter by clinic attendances and/or review of hand-held health records. Presentations with non-malarial illness were also recorded. Differences between allocated treatments for pre-specified endpoints were determined using Kaplan-Meier survival analysis. Results: Of 247 children who were followed to Day 42, 176 (71.3%) were included in the present sub-study, 87 allocated to AM-LM and 89 to artemisinin-NQ. Twenty children in the AM-LM group (32.8%) had a first episode of clinical malaria within six months compared with 10 (16.4%) in the artemisinin-NQ group (P=0.033, log rank test). The median (interquartile range) time to first episode of clinical malaria was 64 (50-146) vs 116 (77-130) days, respectively (P=0.20). There were no between-group differences in the incidence of first presentation with non-malarial illness (P=0.31). Conclusions: The greater effectiveness of artemisinin-NQ over conventional AM-LM extends to at least six months post-treatment for clinical malaria but not non-malarial illness. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12610000913077.

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