title: High efficacy of two artemisinin-based combinations: artesunate + sulfadoxine-pyrimethamine and artemether-lumefantrine for falciparum malaria in Yemen.
abstract: BACKGROUND
  Artesunate + sulfadoxine-pyrimethamine (AS + SP) has been the first-line treatment and artemether-lumefantrine (AL) the second-line treatment for uncomplicated falciparum malaria in Yemen since 2005. This paper reports the results of studies conducted to monitor therapeutic efficacy of these two drugs in sentinel sites in Yemen.
  
  
  METHODS
  Eight therapeutic efficacy studies were conducted in six sentinel sites during the period 2009-2013 in Yemen. Five studies were for the evaluation of AS + SP (total of 465 patients) and three studies (total of 268 patients) for the evaluation of AL. The studies were done according to standard WHO protocol 2009 with 28-day follow-up.
  
  
  RESULTS
  In the evaluation of AS + SP, the PCR-corrected cure rate was 98 % (95 % CI 92.2-99.5 %) in one site and 100 % in all of the other four sites. In the sites where AL was evaluated, the PCR-corrected cure rate was 100 % in all the sites. All patients were negative for asexual parasitaemia on day 3 in both the AS + SP and the AL groups. There was a higher rate of clearance of gametocytaemia in the AL-treated group when compared with the AS + SP groups from day 7 onwards.
  
  
  CONCLUSIONS
  AS + SP remains the effective drug for uncomplicated falciparum malaria in Yemen. AL is also highly effective and can be an appropriate alternative to AS + SP for the treatment of falciparum malaria. AL demonstrated a higher efficacy in clearing microscopic gametocytaemia than AS + SP.
  
  
  BACKGROUND
  Trial registration number ACTRN12610000696099.
authors.affiliation: College of Medicine, King Saud University, Riyadh, Saudi Arabia. aaadeel@yahoo.com.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Adeel
authors.affiliation: The National Malaria Control Programme, Ministry of Public Health and Population, Sanaa, Yemen. niazabdo@yahoo.com.
authors.forename: Niaz Abdo
authors.initials: NA
authors.lastname: Saeed
authors.affiliation: The National Malaria Control Programme, Ministry of Public Health and Population, Sanaa, Yemen. aljasari@hotmail.com.
authors.forename: Adel
authors.initials: A
authors.lastname: Aljasari
authors.affiliation: Ministry of Public Health and Population, Sanaa, Yemen. almohaget76@gmail.com.
authors.forename: Amar M
authors.initials: AM
authors.lastname: Almohager
authors.affiliation: Ministry of Public Health and Population, Sanaa, Yemen. Dr.ghalab.husami@gmail.com.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Galab
authors.affiliation: Ministry of Public Health and Population, Sanaa, Yemen. Amaryahya2016@gmail.com.
authors.forename: Amar
authors.initials: A
authors.lastname: AlMahdi
authors.affiliation: Ministry of Public Health and Population, Sanaa, Yemen. mansour777788436@gmail.com.
authors.forename: Mansor H
authors.initials: MH
authors.lastname: Mahammed
authors.affiliation: Ministry of Public Health and Population, Sanaa, Yemen. Mohammedaldarasi@yahoo.com.
authors.forename: Mohammed
authors.initials: M
authors.lastname: AlDarsi
authors.affiliation: Ministry of Public Health and Population, Sanaa, Yemen. yaamer2010@gmail.com.
authors.forename: Yahiya A
authors.initials: YA
authors.lastname: Salaeah
authors.affiliation: Malaria Control and Elimination, Division of Communicable Diseases Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt. attah@who.int.
authors.forename: Hoda
authors.initials: H
authors.lastname: Atta
authors.affiliation: Malaria Control and Elimination, Division of Communicable Diseases Control, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt. zamanig@who.int.
authors.forename: Ghasem
authors.initials: G
authors.lastname: Zamani
authors.affiliation: Global Malaria Programme, World Health Organization, Geneva, Switzerland. warsamem@who.int.
authors.forename: Marian
authors.initials: M
authors.lastname: Warsame
authors.affiliation: Global Malaria Programme, World Health Organization, Geneva, Switzerland. barrettea@who.int.
authors.forename: Amy
authors.initials: A
authors.lastname: Barrette
authors.affiliation: Naval Medical Research Unit-3, Cairo, Egypt. Hanan.ElMohammady.eg@med.navy.mil.
authors.forename: Hanan El
authors.initials: HE
authors.lastname: Mohammady
authors.affiliation: Naval Medical Research Unit-3, Cairo, Egypt. Rania.AbdelKhalek.eg@med.navy.mil.
authors.forename: Rania A
authors.initials: RA
authors.lastname: Nada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D004983:Ethanolamines / Q000008:administration & dosage*; D005449:Fluorenes / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011739:Pyrimethamine / Q000008:administration & dosage*; D013413:Sulfadoxine / Q000008:administration & dosage*; D016896:Treatment Outcome; D015006:Yemen; D055815:Young Adult
chemical_list: D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; C578917:sulfadoxine-pyrimethamine-artesunate; D013413:Sulfadoxine; D011739:Pyrimethamine