Evidence map›Paper›PMID 38594679›Full record

ArticleMalaria journal2024

Efficacy and safety of artemether-lumefantrine for the treatment of uncomplicated falciparum malaria in mainland Tanzania, 2019.

Billy E Ngasala, Mercy G Chiduo, Bruno P Mmbando, Filbert T Francis, Samwel Bushukatale, Twilumba Makene, Celine I Mandara, Deus S Ishengoma, Erasmus Kamugisha, Maimuna Ahmed and 14 more

Open access · goldAbstract read
In one paragraph

Article in Malaria journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 8 institutions in 2 countries.

Billy E NgasalaDepartment of Parasitology, School of Public Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. bngasala70@gmail.com.
Mercy G ChiduoNational Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
Bruno P MmbandoNational Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
Filbert T FrancisNational Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
Samwel BushukataleDepartment of Parasitology, School of Public Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Twilumba MakeneDepartment of Parasitology, School of Public Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Celine I MandaraNational Institute for Medical Research, Headquarters, Dar es Salaam, Tanzania.
Deus S IshengomaNational Institute for Medical Research, Headquarters, Dar es Salaam, Tanzania.
Erasmus KamugishaCatholic University of Health and Allied Sciences, Bugando Medical Centre, Mwanza, Tanzania.
Maimuna AhmedCatholic University of Health and Allied Sciences, Bugando Medical Centre, Mwanza, Tanzania.
Muhidin K MahendeIfakara Health Institute, Dar-es-Salaam, Tanzania.
Reginald A KavisheKilimanjaro Christian Medical Centre, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Florida MuroKilimanjaro Christian Medical Centre, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Fabrizio MolteniNational Malaria Control Program, Dodoma, Tanzania.
Erik ReavesU.S. President's Malaria Initiative, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
Chonge KitojoU.S. President's Malaria Initiative, U.S. Agency for International Development, Dar es Salaam, Tanzania.
George GreerU.S. President's Malaria Initiative, U.S. Agency for International Development, Dar es Salaam, Tanzania.
Ssanyu NyinondiR.T.I. International, Dar es Salaam, Tanzania.
Bilal KabulaR.T.I. International, Dar es Salaam, Tanzania.
Shabbir LaljiR.T.I. International, Dar es Salaam, Tanzania.
Frank ChackyNational Malaria Control Program, Dodoma, Tanzania.
Ritha J NjauMuhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.
Marian WarsameGothenburg University, Gothenburg, Sweden.
Ally MohamedNational Malaria Control Program, Dodoma, Tanzania.
National Institute for Medical Research · TZMuhimbili University of Health and Allied Sciences · TZAfrican Malaria Network Trust · TZKilimanjaro Christian Medical Centre · TZBugando Medical Centre · TZCatholic University of Health and Allied Sciences · TZIfakara Health Institute · TZUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundArtemisinin-based combination therapy (ACT) has been a major contributor to the substantial reductions in global malaria morbidity and mortality over the last decade. In Tanzania, artemether-lumefantrine (AL) was introduced as the first-line treatment for uncomplicated Plasmodium falciparum malaria in 2006. The World Health Organization (WHO) recommends regular assessment and monitoring of the efficacy of the first-line treatment, specifically considering that artemisinin resistance has been confirmed in the Greater Mekong sub-region. This study's main aim was to assess the efficacy and safety of AL for treating uncomplicated P. falciparum malaria in Tanzania.

methodsThis was a single-arm prospective antimalarial drug efficacy trial conducted in four of the eight National Malaria Control Programme (NMCP) sentinel sites in 2019. The trial was carried out in outpatient health facilities in Karume-Mwanza region, Ipinda-Mbeya region, Simbo-Tabora region, and Nagaga-Mtwara region. Children aged six months to 10 years with microscopy confirmed uncomplicated P. falciparum malaria who met the inclusion criteria were recruited based on the WHO protocol. The children received AL (a 6-dose regimen of AL twice daily for three days). Clinical and parasitological parameters were monitored during follow-up over 28 days to evaluate drug efficacy.

resultsA total of 628 children were screened for uncomplicated malaria, and 349 (55.6%) were enrolled between May and September 2019. Of the enrolled children, 343 (98.3%) completed the 28-day follow-up or attained the treatment outcomes. There were no early treatment failures; recurrent infections during follow-up were common at two sites (Karume 29.5%; Simbo 18.2%). PCR-corrected adequate clinical and parasitological response (ACPR) by survival analysis to AL on day 28 of follow-up varied from 97.7% at Karume to 100% at Ipinda and Nagaga sites. The commonly reported adverse events were cough, skin pallor, and abdominal pain. The drug was well tolerated, and no serious adverse event was reported.

conclusionThis study showed that AL had adequate efficacy and safety for the treatment of uncomplicated falciparum malaria in Tanzania in 2019. The high recurrent infections were mainly due to new infections, highlighting the potential role of introducing alternative artemisinin-based combinations that offer improved post-treatment prophylaxis, such as artesunate-amodiaquine (ASAQ).

Indexed as

AntimalarialsArtemisininsMalariaMalaria, FalciparumAmodiaquineArtemetherArtemether, Lumefantrine Drug CombinationChildDrug CombinationsHumansInfantPlasmodium falciparumProspective StudiesReinfectionTanzaniaTreatment OutcomeAmodiaquineAntimalarialsArtemetherArtemether, Lumefantrine Drug CombinationartemisininArtemisininsDrug CombinationsArtemether-LumefantrineMalariaPlasmodium falciparumTherapeutic efficacy

Identifiers

PMID38594679
PMCPMC11005286
OpenAlexW4394599129

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.