Comparison of the efficacy of artemether-lumefantrine vs. artesunate plus sulfadoxine-pyrimethamine in children with uncomplicated falciparum malaria

Background World Health Organization (WHO) has recommended that countries with drug resistant malaria problem use combination therapies, especially artemisinin-based combination therapy (ACT). However, there is limited information on the efficacy of ACT in North Sulawesi. Objective To compare the efficacy of artemether-lumefantrine and artesunate plus sulfadoxine-pyrimethamine (SP). Methods This was a randomized experimental study, conducted in Prof. Dr. R. D. Kandou General Hospital, Manado from January until July 2009. There were 42 patients aged less than 13 years treated with artemether-lumefantrine and artesunate plus SP. Body temperature, parasite and gametocyte count were recorded every day until day 7 and follow-up reviews were done on day 14 and 78. Results Fever clearance time showed a significant difference between artemether-lumefantrine group (median 27 hours) and artesunate plus SP group (median 18 hours), P < 0.05). There was no significant difference in parasite clearance time (P > 0.05) and gametocyte clearance time (P > 0.05). The 28 day cure rate were 100% in the two groups. No side effect was found. Conclusion Both artemether-lumefantrine and artesu nate plus SP combination are effective and safe for the treatment of falciparum malaria in children.