A randomized, comparative study of two regimens of β-artemether for the treatment of uncomplicated, Plasmodium falciparum malaria, in northern Ghana

Abstract In Ghana, wide-spread resistance to chloroquine has necessitated the drug's replacement as the first-line treatment for malaria, both to increase the likelihood of cure and to reduce transmission. To see if β-artemether could be a suitable alternative to chloroquine, 223 adults (aged ≥ 15 years) with uncomplicated, Plasmodium falciparum malaria were each given a total dose of 480 mg β-artemether over 4 or 5 days. The patients were randomly allocated to receive an initial, loading dose of 80 or 160 mg, and were checked on days 1, 2, 3, 4 (or 5), 7 and 14, for fever clearance and any adverse events. Blood samples collected on days 0, 4 (or 5), 7 and 14 were smeared so that levels of parasitaemia could be evaluated. Haemoglobin concentrations on days 0 and 14 were also determined. In terms of the clinical cure 'rates' estimated in the intention-to-treat analysis (92.5% v. 97.4%) and the evaluability analysis (98.9% v. 100%), and of the frequency of parasitological cure by day 14 (97.0% v. 96.5%), the patients given an initial dose of 80 mg were similar to those given 160 mg as the loading dose. The regimen with the 160-mg loading dose appears as safe and as effective as the regimen with an initial dose of 80 mg. Since the regimen with the higher loading dose is shorter and involves fewer treatments than the other regimen, it would probably be associated with better compliance.