Prospective evaluation of artemether-lumefantrine for the treatment of non-falciparum and mixed-species malaria in Gabon

This study prospectively observed the efficacy of artemether-lumefantrine for the treatment of uncomplicated non-falciparum or mixed-species malaria in two routine district hospitals in the Central African country of Gabon.Forty patients suffering from uncomplicated Plasmodium malariae, Plasmodium ovale or mixed-species malaria (including Plasmodium falciparum) presenting at the hospital received artemether-lumefantrine treatment and were followed up. All evaluable patients (n？=？38) showed an adequate clinical and parasitological response on Day 28 after oral treatment with artemether-lumefantrine (95% confidence interval: 0.91,1). All adverse events were of mild to moderate intensity and completely resolved by the end of study.This first systematic assessment of artemether-lumefantrine treatment for P. malariae, P. ovale and mixed-species malaria demonstrated a high cure rate of 100% and a favourable tolerability profile, and thus lends support to the practice of treating non-falciparum or mixed-species malaria, or all cases of malaria without definite species differentiation, with artemether-lumefantrine in Gabon.ClinicalTrials.gov Identifier: NCT00725777Effective treatment of malaria is one of the main tools to control and eventually eradicate malaria. A plethora of clinical trials demonstrating high efficacy, satisfying effectiveness, and good tolerability and safety of artemisinin combination therapy (ACT) – the current first-line treatment of falciparum malaria – has been conducted and published over the past decade [1,2]. Treatment recommendations for non-falciparum malaria have however remained virtually unchanged since the introduction of chloroquine more than five decades ago [3].Plasmodium falciparum and to a lesser extent Plasmodium vivax have attracted more scientific interest compared to the other human plasmodial species due to their high incidence, virulence and the emergence of drug resistant isolates. Today Plasmodium ovale and Plasmodium malariae