Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia.
Infect Dis Poverty. 2017 Nov 15;6(1):157. doi: 10.1186/s40249-017-0372-5.
As Ethiopia is one of the sub-Saharan countries with a great burden of malaria the effectiveness of first line anti-malarial drugs is the major concern. The aim of this study was to synthesize the available evidence on the efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia. This was done by performing a meta-analysis of recent studies conducted in the country on this topic.
Studies published between January 2010 and January 2017 that reported on the efficacy of artemether-lumefantrine in the treatment of P. falciparum malaria in Ethiopian patients were searched for using the PubMed and Google Scholar databases. Ten prospective single-arm cohort studies that followed patients for 28-42 days were included in this analysis. All of the included studies were deemed to be of high quality.
Ten studies involving 1179 patients that were eligible for meta-analysis were identified. At recruitment, the average parasite count per patient was 1 2981/μl of blood. On the third day of treatment, 96.7% and 98.5% of the study subjects become fever-free and parasite-free, respectively. Based on the per protocol analysis, the cure rate after use of artemether-lumefantrine was 98.2% (polymerase chain reaction corrected) and 97.01% (polymerase chain reaction uncorrected) after 28 days of follow-up. The reinfection rate within 28 days was 1.1% and the recrudescence rate was 1.9%.
This review found that the cure rate for uncomplicated P. falciparum malaria using artemether-lumefantrine in Ethiopia is still high enough to recommend the drug as a first-line agent. There should be careful periodic monitoring of the efficacy of this drug, as treatment failure may occur due to resistance, sub-therapeutic levels that may occur due to non-adherence, or inadequate absorption.
埃塞俄比亚是撒哈拉以南疟疾负担沉重的国家之一，因此一线抗疟药物的疗效是主要关注点。本研究旨在对在该国开展的关于青蒿琥酯-咯萘啶治疗无并发症恶性疟的疗效进行综合分析。这是通过对该主题的近期研究进行荟萃分析来完成的。
检索了 2010 年 1 月至 2017 年 1 月期间在 PubMed 和 Google Scholar 数据库中发表的关于青蒿琥酯-咯萘啶治疗埃塞俄比亚患者恶性疟疗效的研究。纳入了本分析的 10 项前瞻性单臂队列研究，这些研究随访了 28-42 天的患者。所有纳入的研究均被认为质量较高。
确定了 10 项符合荟萃分析条件的研究，共涉及 1179 例患者。在招募时，每位患者的平均寄生虫计数为 12981/μl 血液。在治疗的第 3 天，分别有 96.7%和 98.5%的研究对象体温正常和寄生虫阴性。根据意向治疗分析，使用青蒿琥酯-咯萘啶后的治愈率在 28 天的随访时为 98.2%（聚合酶链反应校正）和 97.01%（聚合酶链反应未校正）。28 天内的再感染率为 1.1%，复发率为 1.9%。
本综述发现，青蒿琥酯-咯萘啶治疗埃塞俄比亚无并发症恶性疟的治愈率仍然足够高，可以推荐该药物作为一线药物。应定期谨慎监测该药的疗效，因为可能由于耐药性、可能由于不依从性而导致的治疗效果不理想或吸收不足而导致治疗失败。
