title: In vivo efficacy of artemether-lumefantrine against uncomplicatedPlasmodium falciparummalaria in Dembia District, northwest Ethiopia.
abstract: BACKGROUND
  Artemether-lumefantrine (AL) has been used as a first-line treatment for uncomplicatedPlasmodium falciparummalaria in Ethiopia since 2004. Antimalarial drug resistance is one of the major obstacles for malaria control and curtails the lifespan of several drugs. Thus, continued monitoring of the efficacy of AL is of great public health importance in malaria endemic areas.
  
  
  OBJECTIVE
  This study aimed to investigate the therapeutic efficacy and safety of AL for the treatment of uncomplicatedP. falciparummalaria in the Dembia district, northwest Ethiopia.
  
  
  METHODS
  A prospective study was conducted from April 2015 to February 2016 at Kola Diba Health Center (KHC) in the Dembia district to determine the therapeutic efficacy and safety of AL for the treatment of uncomplicatedP. falciparummonoinfection. Patients were treated with the six-dose regimen of AL over 3 days and followed up for 28 days as per the World Health Organization protocol.
  
  
  RESULTS
  Of the total 80 patients enrolled in the AL efficacy study, 75 patients completed the 28 days follow-up. None of the participants reported major adverse events. No early treatment failure or late clinical failure were observed during the study, but there were 6 (8.0%) late parasitological failures. The uncorrected per protocol cure rate of AL was 92.0 (95% CI: 85.7-98.3). Treatment with AL cleared parasitemia and fever in >95% of the patients by day 3.
  
  
  CONCLUSIONS
  This study showed that AL is well tolerated and remains efficacious for treatment of uncomplicatedP. falciparummalaria in northwest Ethiopia. However, the observed late parasitological failures in this study are of a concern and warrant continued monitoring of drug efficacy as per the World Health Organization recommendations.
authors.affiliation: School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Tekalign
authors.initials: T
authors.lastname: Deressa
authors.affiliation: School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; Australian Institute Tropical Health and Medicine, James Cook University, Cairns, Australia.
authors.forename: Mengistu Endris
authors.initials: ME
authors.lastname: Seid
authors.affiliation: School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Wubet
authors.initials: W
authors.lastname: Birhan
authors.affiliation: School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Yetemwork
authors.initials: Y
authors.lastname: Aleka
authors.affiliation: School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia.
authors.forename: Biniam Mathewos
authors.initials: BM
authors.lastname: Tebeje
keywords: Ethiopia; antimalarial efficacy; artemether-lumefantrine; malaria; uncomplicated Plasmodium falciparum