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Artemisinin-based combinations.

Elizabeth A Ashley1, Nicholas J White

  • 1Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand.

Current Opinion in Infectious Diseases
|November 1, 2005
PubMed
Summary
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Artemisinin-based combination treatments are highly effective and safe for treating malaria. Making these essential medicines accessible in tropical countries is crucial for malaria control.

Area of Science:

  • Tropical Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Artemisinin-based combination treatments (ACTs) are the primary therapy for falciparum malaria in Southeast Asia.
  • ACTs are increasingly recommended globally as first-line malaria treatment.

Purpose of the Study:

  • To review the efficacy and safety of artemisinin-based combination treatments.
  • To highlight the role of ACTs in malaria control strategies.

Main Methods:

  • Review of a large multicentre randomized trial in East Asia.
  • Evaluation of evidence on the safety and efficacy of various ACTs, including artemether-lumefantrine and dihydroartemisinin-piperaquine.
  • Assessment of clinical trial data from Africa and Southeast Asia.

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Main Results:

  • Parenteral artesunate reduced mortality from severe malaria by 35% compared to quinine in a large East Asian trial.
  • Artemisinin-based combination treatments demonstrate increasing evidence of safety and rapid effectiveness.
  • Artemether-lumefantrine (six-dose regimen) and dihydroartemisinin-piperaquine (three-dose regimen) showed high efficacy and tolerability in trials from Uganda, Tanzania, and Southeast Asia, including for drug-resistant malaria.

Conclusions:

  • Early diagnosis and prompt treatment with effective antimalarials are vital for malaria control.
  • Artemisinin-based combination treatments are consistently effective and safe.
  • Improving accessibility of ACTs in tropical regions remains a significant challenge.