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Treatment of Uncomplicated in Vitro Chloroquine Resistant Falciparum Malaria with Artemether in Irian Jaya
Chloroquine resistant malaria is a serious problem in Indonesia especially in Irian Jaya. Artemether is a new antimalarial drug, reported to be very effective and safe in clinical studies. This drug is not yet available in Indonesia. To obtain an alternative antimalarial drug for the treatment of chloroquine resistant falciparum malaria cases, a trial of artemether treatment for uncomplicated falciparum malaria was conducted at Freeport ospital, Tembagapura, Irian Jaya, Indonesia in April - November 1994. The objective of the study was to assess the efficacy and tolerance of artemether. Sixty-six out of 307 uncomplicated falciparum malaria cases were elligible for in vitro sensitivity tests. Only 44 of the 54 uncomplicated in vitro chloroquine resistant falciparum malaria patients could be recruited in this study. They were treated orally with 1.6 mg/kg b.i.d on day 0 and followed by a daily dose on day 1-4. All patients were hospitalized until clinically and parasitologically cured. The most frequent symptoms and signs of these patients were headache (82 percent), pallor (55 percent), fever (41 percent) and chills (39 percent). The parasite clearance rate of artemether was 100 percent (38/38, 31/31) on day 7, day 14, and day 21. However this was reduced to 90.3 percent (28/31) on day 28 because of the presence of 3 (9.7 percent) recrudescence cases. The mean fever clerance times and parasite clearance times were as follow : 9 plus minus 10 hours and 31 plus minus 10 hours (day 7, day 14), 8 plus minus 10 hours and 30 plus minus 9 (day 21), 8 plus minus 10 hours and 29 plus minus 9 hours (day 28) respectively. Abdominal pain (7.9 percent) and diarrhoea (5.3 percent) were noted as the side effects of artemether, both mild and self-limiting. Artemether is effective and well tolerated for the treatment of uncomplicated in vitro chloroquine resistant falciparum malaria until day 2a1 in Timika, Irian Jaya. Modification of artemether dosage and schedule or combination of artemether with other antimalarial drugs should be studied to achieve a radical cure.
A00001693 | Available |
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