Confirmed Vivax Resistance to Chloroquine and Effectiveness of Artemether-Lumefantrine for the Treatment of Vivax Malaria in Ethiopia

Ambachew M. Yohannes World Health Organization Country Office, Addis Ababa, Ethiopia; Mailman School of Public Health and the Earth Institute, Columbia University, New York, New York; Dalarna University College, Borlänge, Sweden; Global Malaria Program, World Health Organization, Geneva, Switzerland

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Awash Teklehaimanot World Health Organization Country Office, Addis Ababa, Ethiopia; Mailman School of Public Health and the Earth Institute, Columbia University, New York, New York; Dalarna University College, Borlänge, Sweden; Global Malaria Program, World Health Organization, Geneva, Switzerland

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Yngve Bergqvist World Health Organization Country Office, Addis Ababa, Ethiopia; Mailman School of Public Health and the Earth Institute, Columbia University, New York, New York; Dalarna University College, Borlänge, Sweden; Global Malaria Program, World Health Organization, Geneva, Switzerland

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Pascal Ringwald World Health Organization Country Office, Addis Ababa, Ethiopia; Mailman School of Public Health and the Earth Institute, Columbia University, New York, New York; Dalarna University College, Borlänge, Sweden; Global Malaria Program, World Health Organization, Geneva, Switzerland

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Chloroquine (CQ) is still the drug of choice for the treatment of vivax malaria in Ethiopia, whereas artemether-lumefantrine (AL) is for falciparum malaria. In this setting, clinical malaria cases are treated with AL. This necessitated the need to assess the effectiveness of AL for the treatment of Plasmodium vivax with CQ as a comparator. A total of 57 (80.3%) and 75 (85.2%) cases treated with CQ or AL, respectively, completed the study in an outpatient setting. At the end of the follow-up period of 28 days, a cumulative incidence of treatment failure of 7.5% (95% confidence interval [CI] = 2.9–18.9%) for CQ and 19% (95% CI = 11–31.6%) for AL was detected. CQ resistance was confirmed in three of five CQ treatment failures cases. The effectiveness of AL seems lower than CQ; however, the findings were not conclusive, because the AL evening doses were not supervised.

Author Notes

*Address correspondence to Ambachew M. Yohannes, World Health Organization, 20 Avenue Appia, CH-1211 Geneva, Switzerland. E-mail: yohannesam@who.int

Authors' addresses: Ambachew M. Yohannes, World Health Organization, Geneva, Switzerland, E-mail: yohannesam@who.int. Awash Teklehaimanot, Mailman School of Public Health and The Earth Institute, Columbia University, New York, NY, E-mail: thawash@ei.columbia.edu. Yngve Bergqvist, Dalarna University College, Borlänge, Sweden, E-mail: ybq@du.se. Pascal Ringwald, Global Malaria Programme, World Health Organization, Geneva, Switzerland, E-mail: ringwaldp@who.int.

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