Artemether and lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa

Abstract

Introduction: WHO Treatment Guidelines recommend that artemisinin-based combination therapies (ACTs) are used to treat uncomplicated Plasmodium falciparum malaria. Artemether plus lumefantrine (AL) is currently approved in 86 countries, with 30 of the 47 sub-Saharan African countries using it as first-line therapy, and 8 as second-line therapy. The dispersible formulation of AL that facilitates administration to infants and children, being simpler for caregivers to prepare and administer than crushed tablets, and easier for sick children and infants to take is discussed.

Areas covered: A descriptive summary of available literature from sub-Saharan Africa demonstrates consistently high efficacy and safety for over a decade, with the majority of reported 28-day PCR-corrected cure rates being above 95%.

Expert opinion: AL is an important antimalarial that will play a major role as countries move towards the elimination of malaria. Further advances in best practice of ACT use will come through strategies to prolong the longevity of ACTs, improved access to ACTs, new data on the use of ACTs in pregnancy, asymptomatic patients and novel paediatric formulations.