[Therapeutic effectiveness and safety of artemether lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in children aged 5 to 15 years in three epidemiological strata of malaria in Niger]

Abstract

Malaria is a major public health issue in Niger. This study aims to provide information on the therapeutic efficacy of antimalarials, specifically focusing on artemether-lumefantrin (AL) in children aged 5 to 15 years in Aderbissinat, Aguié, and Baban Tabki. To evaluate the therapeutic efficacy of AL in children in the specified regions. The study was conducted from August 26 to October 25, 2022, using the standard WHO/2015 28-day follow-up method. Biological confirmation was done using rapid diagnostic tests (RDT) and microscopy, while PCR was used to distinguish between reinfections and recrudescences. Out of 352 suspected malaria patients, 263 were included in the study. There were 5 lost to follow-up, 1 voluntary withdrawal, and 3 protocol violations. The malaria prevalence was 92%, with an average parasite density of 42,606 P/μL and a sex-ratio of 1.02. The overall adequate clinical and parasitological response (ACPR) after PCR correction was 97.25%, with 100% in Aderbissinat and Aguié, and 90% in Baban Tabki. No major adverse events were recorded. The results support the use of AL for the treatment of uncomplicated malaria as per the National Malaria Control Program (NMCP).

Keywords: Niger; artemether; effectiveness; lumefantrin; malaria; tolérance.