Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 12;105(3):670-676.
doi: 10.4269/ajtmh.21-0086.

Efficacy of Artemether-Lumefantrine for the Treatment of Plasmodium falciparum Malaria in Bohicon and Kandi, Republic of Benin, 2018-2019

Augustin Kpemasse  1 , Fortune Dagnon  2 , Ramani Saliou  1 , Alexis Sacca Yarou Maye  1 , Cyriaque Dossou Affoukou  1 , Alassane Zoulkaneri  3 , Blaise Guézo-Mévo  4 , Leah F Moriarty  5 , Yaye D Ndiaye  6 , Mamane Nassirou Garba  6 , Awa Bineta Deme  6 , Daouda Ndiaye  6 , Aurore Ogouyemi Hounto  1
Affiliations

Efficacy of Artemether-Lumefantrine for the Treatment of Plasmodium falciparum Malaria in Bohicon and Kandi, Republic of Benin, 2018-2019

Augustin Kpemasse et al. Am J Trop Med Hyg. .

Abstract

In 2005, artemether-lumefantrine (AL), an artemisinin-based combination therapy, was introduced as the first-line treatment of uncomplicated Plasmodium falciparum malaria in Benin. Per World Health Organization recommendations to monitor the efficacy of antimalarial treatment, we conducted a therapeutic efficacy study with AL for uncomplicated P. falciparum malaria in Bohicon and Kandi, Benin, from 2018 to 2019. Febrile patients aged 6 to 59 months with confirmed P. falciparum monoinfection received supervised doses of AL for 3 days. We monitored patients clinically and parasitologically on days 1, 2, 3, 7, 14, 21, and 28. A molecular analysis to detect mutations in the P. falciparum Kelch propeller gene (Pfk13) gene was carried out on day 0 samples. A total of 205 patients were included in the study. In Bohicon, the uncorrected adequate clinical and parasitological response (ACPR) proportion was 91.3% (95% confidence interval [CI]: 84.6-95.8%), whereas in Kandi this proportion was 96.7% (95% CI: 90.6-99.3%). Genotype-corrected ACPR proportions were 96.3% (95% CI: 90.9-99.0%) and 96.7% (95% CI: 90.6-99.3%) in Bohicon and Kandi, respectively. On day 3, 100% of patients in Bohicon and 98.9% of patients in Kandi had undetectable parasitemia. The C580Y mutation in the Pfk13 gene was not observed. AL remains effective for P. falciparum malaria in these two sites in Benin. Monitoring antimalarial efficacy and prevalence of molecular-resistance markers in Benin should be continued to allow for early detection of antimalarial resistance and to guide treatment policies.

PubMed Disclaimer

Conflict of interest statement

Disclaimer: The funding sources for this study had no role in study design, data collection, analysis, or interpretation. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the Benin National Malaria Control Program, U.S. Agency for International Development, or the Centers for Disease Control and Prevention.

Figures

Figure 1.
Figure 1.
Bohicon and Kandi municipalities, sites for antimalarial therapeutic efficacy monitoring, Benin, 2018–2019. This figure appears in color at www.ajtmh.org.
Figure 2.
Figure 2.
Screening, enrollment, and follow-up of study participants, Bohicon and Kandi, Benin, 2018–2019 (N = 205). Note: In Kandi, 90 patients screened in the first enrollment phase in 2018 and 100 in the second in 2019 (see text for details).
Figure 3.
Figure 3.
Genotype-corrected day 28 adequate clinical and parasitological response (ACPR) survival curve per site, Bohicon and Kandi, Benin (N = 205). This figure appears in color at www.ajtmh.org.
See this image and copyright information in PMC

References

    1. World Health Organization , 2020. World Malaria Report 2020: 20 Years of Global Progress and Challenges. Geneva, Switzerland: WHO. Available at: https://www.who.int/publications/i/item/9789240015791.
    1. Santé Mdl, 2019. Annuaire des statistiques sanitaires. Cotonou, Benin: Santé Mdl, 144.
    1. Haldar K, Bhattacharjee S, Safeukui I, 2018. Drug resistance in Plasmodium. Nat Rev Microbiol 16: 156–170. - PMC - PubMed
    1. World Health Organization , 2015. Guidelines for the Treatment of Malaria. Available at: https://www.who.int/docs/default-source/documents/publications/gmp/guide.... Accessed April 6, 2021.
    1. World Health Organization , 2009. Methods for Surveillance of Antimalarial Drug Efficacy. Geneva, Switzerland: WHO. Available at: https://apps.who.int/iris/bitstream/handle/10665/44048/9789241597531_eng....

Publication types

Substances

LinkOut - more resources