Short-course artesunate treatment of uncomplicated Plasmodium falciparum malaria in Gabon

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Mar. 2003, p. 901–904 0066-4804/03/$08.00⫹0 DOI: 10.1128/AAC.47.3.901–904.2003 Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Vol. 47, No. 3

Short-Course Artesunate Treatment of Uncomplicated Plasmodium falciparum Malaria in Gabon Steffen Borrmann,1,2* Ayola A. Adegnika,1,2 Michel A. Missinou,1,2 Ronald K. Binder,1 Saadou Issifou,1,2 Andreas Schindler,1 Pierre-Blaise Matsiegui,1 Ju ¨rgen F. J. Kun,2 3 1,2 Sanjeev Krishna, Bertrand Lell, and Peter G. Kremsner1,2 Medical Research Unit, Albert Schweitzer Hospital, Lambare´ne´, Gabon1; Department of Parasitology, Institute of Tropical Medicine, University of Tu ¨bingen, Tu ¨bingen, Germany2; and Department of Infectious Diseases, St. George’s Medical School Hospital, London, United Kingdom3 Received 29 July 2002/Returned for modification 2 November 2002/Accepted 25 November 2002

Artesunate is one of the most important antimalarial agents available, since it is effective against parasites that have developed resistance to conventional antimalarials in sub-Saharan Africa. Antimalarial combination chemotherapies with artesunate (4 mg/kg of body weight once daily for 3 days) as one partner have been proposed. However, the efficacy of a 3-day course of artesunate alone has never been evaluated in individuals in Africa (which has 90% of the worldwide malaria burden) living in regions of hyperendemicity, where a considerable degree of immunity might substantially enhance the efficacy of short courses of artesunate compared to those in regions where the levels of endemicity are low. This lack of information does not permit a systematic assessment of the value of artesunate-based combination chemotherapies in Africa. Therefore, we studied the efficacy and safety of a 3-day course of artesunate (4 mg/kg of body weight, orally, once daily) for the treatment of uncomplicated Plasmodium falciparum malaria in Gabonese patients aged 4 to 15 years (n ⴝ 50). Artesunate was well tolerated, and no severe adverse event was reported. Parasite elimination was rapid and was achieved in all patients within