title: Evaluation of recurrent parasitemia after artemether-lumefantrine treatment for uncomplicated malaria in children in western Kenya.
abstract: From April 2005 to April 2006, a phase 2 malaria vaccine trial in Kenya enrolled 400 children aged 12-47 months. Each received mixed supervised and unsupervised artemether-lumefantrine for uncomplicated malaria, using a standard six-dose regimen, by weight. Children were followed for detection of parasitemia and clinical malaria. A median of two negative malaria blood films occurred during every recurrent parasitemia (RP) episode, suggesting reinfection over late recrudescence. Median time to RP after starting artemether-lumefantrine was 37 days (36-38). Of 2,020 evaluable artemether-lumefantrine treatments, there were no RPs in 99% by day 14, 71% by day 28, and 41% by day 42. By World Health Organization standards, 71% of treatment courses had adequate responses. Although recrudescence in some cannot be ruled out, our cohort had a shorter median time to RP compared with other artemether-lumefantrine treatment studies. This underscores patient counseling on completing all treatment doses for optimal protection from RP.
authors.affiliation: Walter Reed Army Institute of Research, Silver Spring, Maryland, USA. joseph.woodring@us.army.mil
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Woodring
authors.forename: Bernhards
authors.initials: B
authors.lastname: Ogutu
authors.forename: David
authors.initials: D
authors.lastname: Schnabel
authors.forename: John N
authors.initials: JN
authors.lastname: Waitumbi
authors.forename: Cara H
authors.initials: CH
authors.lastname: Olsen
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Walsh
authors.forename: D Gray
authors.initials: DG
authors.lastname: Heppner
authors.forename: Mark E
authors.initials: ME
authors.lastname: Polhemus
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000627:therapeutic use*; D002675:Child, Preschool; D004338:Drug Combinations; D004983:Ethanolamines / Q000627:therapeutic use*; D005449:Fluorenes / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007630:Kenya; D008288:Malaria / Q000097:blood / Q000188:drug therapy* / Q000469:parasitology; D017780:Malaria Vaccines / Q000008:administration & dosage; D010961:Plasmodium / Q000145:classification / Q000302:isolation & purification; D012008:Recurrence
chemical_list: D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; D017780:Malaria Vaccines
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