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

Laman, M; Benjamin, JM; Moore, BR; Salib, M; Tawat, S; Davis, WA; Siba, PM; Robinson, LJ; Davis, TM

Author(s): Laman, M; Benjamin, JM; Moore, BR; Salib, M; Tawat, S; Davis, WA; Siba, PM; Robinson, LJ; Davis, TM;
Details: Publication Year 2015,Volume 14,Issue #1,Page 121
Journal Title: Malaria Journal
Publication Type: Journal Article
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 .
Publisher: BioMed Central
Research Division(s): Population Health And Immunity
PubMed ID: 25889150
Publisher's Version: https://doi.org/10.1186/s12936-015-0624-4
Open Access at Publisher's Site: http://www.malariajournal.com/content/14/1/121
NHMRC Grants: NHMRC/1016443,
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2015-05-20 10:11:22

Last Modified: 2019-04-01 09:09:33