Audit of efficacy of Coartem™ to clear plasmodium falciparum malaria parasitaemia at single forty-two day follow-up.

Abstract

Background: A follow-up study was undertaken to assess the efficacy of CoartemTM tablets (20 mg artemether and 120 mg lumefantrine – Novartis South Africa (Pty) Ltd) to clear plasmodium falciparum malaria parasitaemia at a single 42-day follow-up, with 42 days being chosen in order to detect early emergence of resistance. The study was performed at Ndumo Clinic and Mosvold Hospital in the Ingwavuma District of KwaZulu-Natal, South Africa in January/February 2002. Method: The study included 37 patients presenting to Ndumo Clinic and two presenting to Mosvold Hospital with uncomplicated malaria diagnosed by symptoms and a positive immunochromographic test (ICT) for plasmodium falciparum. The main outcome measures were Trophozoite counts on thick film and polymerase chain reaction parasite analysis of blood spot at day 42. Results: Only 31 of the 37 recruited patients were confirmed to be suffering from malaria by polymerase chain reaction (PCR). Of the 31, 24 returned for follow-up. One patient had parasitaemia at day 33, but tested negative at day 42 after re-treatment with Coartem™. It was not determined whether this patient was suffering from a recrudescence or re-infection of falciparum malaria. All the other returning patients tested negative for falciparum malaria on blood film and PCR examination. Conclusions: CoartemTM still appears to be an effective treatment for falciparum malaria. Regular assessment of its efficacy is desirable. (SA Fam Pract 2004;46(6): 21-24)