Lumefantrine plasma concentrations in uncontrolled conditions among patients treated with artemether-lumefantrine for uncomplicated plasmodium falciparum malaria in Mwanza, Tanzania

• Background: Therapeutic efficacy of artemether-lumefantrine is highly dependent on adequate systemic exposure to the partner drug lumefantrine particularly day 7 lumefantrine plasma concentration. There has been contradicting findings on the role of the cut-off values in predicting treatment outcomes among malaria patients in malaria endemic regions. This study assesses the day 3 and 7 lumefantrine plasma concentrations including related determinant factors and their influence on treatment outcomes among treated Tanzanian children and adults in uncontrolled conditions (real life condition).Methods: Data was nested from an efficacy study employing the WHO protocol, 2015 for monitoring antimalarial drug efficacy. Lumefantrine plasma concentration was measured by high performance liquid chromatography with ultraviolet (HPLC-UV).Results: Lumefantrine plasma concentrations below 175ng/ml and 20 0ng/ml on day 3 and 7 did not affect adequate clinical and parasitological response (ACPR) and recurrence of infection ( p = 0.428 and 0.239 respectively). Age and baseline parasitemia were not as-sociated to day 3 median lumefantrine plasma concentrations (p = 0.08 and 0.31 respectively) and day 7 lumefantrine plasma concentrations (p = 0.07 and 0.41 respectively). However, the day 3 and day 7 lumefantrine plasma concentrations were significantly higher in males compared to females ( p = 0.03 and 0.042 respectively).Conclusion: Lumefantrine plasma concentrations below cut-off points (175ng/ml and 20 0ng/ml) on day 3 and 7 did not influence treatment outcomes.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinsk bioteknologi -- Medicinsk bioteknologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Medical Biotechnology -- Medical Biotechnology (hsv//eng)

Keyword

Lumefantrine

day 7 concentration

day 3 concentration

treatment outcomes and Tanzania

Publication and Content Type

ref (subject category)

art (subject category)