oa South African Family Practice - Audit of efficacy of CoartemTM to clear plasmodium falciparum malaria parasitaemia at single forty-two day follow-up : original research
<i>Background:</i> A follow-up study was undertaken to assess the efficacy of Coartem<sup>TM</sup> tablets (20 mg artemether and 120 mg lumefantrine - Novartis South Africa (Pty) Ltd) to clear <i>plasmodium falciparum</i> 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. <br><i>Method:</i> 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 <i>plasmodium falciparum.</i> The main outcome measures were Trophozoite counts on thick film and polymerase chain reaction parasite analysis of blood spot at day 42. <br><i>Results:</i> 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(tm). 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. <br><i>Conclusions:</i> Coartem<sup>TM</sup> still appears to be an effective treatment for falciparum malaria. Regular assessment of its efficacy is desirable.
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