Anti-malaria drug combination could help address treatment crisis...( the children who received artemether-lu...),Health

Dr Mutabingwa concludes: "We found that the artemether-lumefantrine combination is effective taken unsupervised. The cost of the drug means that it is likely to reach only a fraction of those who need it, unless the price is substantially reduced either through market mechanisms or, more realistically, through subsidy."

FURTHER EVIDENCE TO SHOW DRUG COMBINATION WORKS IN REALISTIC AFRICAN SETTING

Also this week's issue of The Lancet an article by Patrice Piola (Epicentre, Paris France) and colleagues describes the results of a randomised trial, which found that the effectiveness of the artemether-lumefantrine drug combination was very high, exceeding 96%, whether given supervised or unsupervised. Adherence to the complicated, twice-daily, three-day regimen might be sub optimal and could reduce the effectiveness of the drug combination. The investigators compared the effectiveness and safety of the drug combination in patients who had all their doses supervised with fatty food intake and in patients who only had their first dose supervised and were given nutritional advice. The trial involved around 960 patients, of all ages, with uncomplicated falciparum malaria in Mbarara, Uganda.

Dr Piola concludes: "We believe that the six-dose regimen of artemether-lumefantrine is a very promising option for the replacing failing antimalarial therapies in Uganda and other African countries. Our experience suggests that providing systematically a short explanation on drug intake to patients at the point of prescription is a simple but important intervention to enhance adherence."

In an accompanying comment Peter Gottfried Kremsner (Instit
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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
21-Apr-2005