Table 5.
Predicted artemether-lumefantrine (AM-LF) treatment outcome (in %) in populations of 10,000 individuals at 63 days follow-up for different treatment scenarios group by dosing regimen (according to Table 2) and geographical region
|
Treatment scenario |
Treatment outcome |
Age-based dosing regimen |
Weight-based dosing regimen |
||||||
|---|---|---|---|---|---|---|---|---|---|
| Global | Africa | Asia | Latin America | Global | Africa | Asia | Latin America | ||
| Full course, i e, twice daily over three days at 0, 8, 24, 36, 48 and 60 hours |
All parasites cleared |
99.83 |
99.81 |
99.83 |
99.81 |
99.83 |
99.82 |
99.85 |
99.82 |
| Parasites below LoD |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
|
| Recrudescence |
0.15 |
0.16 |
0.15 |
0.16 |
0.15 |
0.15 |
0.13 |
0.15 |
|
| Parasites always above LoD |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
|
| Fifth dose missed |
All parasites cleared |
99.78 |
99.75 |
99.77 |
99.68 |
99.79 |
99.75 |
99.78 |
99.68 |
| Parasites below LoD |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
|
| Recrudescence |
0.20 |
0.22 |
0.21 |
0.29 |
0.19 |
0.22 |
0.20 |
0.29 |
|
| Parasites always above LoD |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
|
| Sixth dose missed |
All parasites cleared |
99.78 |
99.75 |
99.77 |
99.68 |
99.79 |
99.75 |
99.78 |
99.68 |
| Parasites below LoD |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
|
| Recrudescence |
0.20 |
0.22 |
0.21 |
0.29 |
0.19 |
0.22 |
0.20 |
0.29 |
|
| Parasites always above LoD |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
|
| Fifth and sixth dose missed |
All parasites cleared |
99.52 |
99.39 |
99.55 |
99.24 |
99.56 |
99.4 |
99.53 |
99.24 |
| Parasites below LoD |
0.02 |
0.01 |
0.02 |
0.02 |
0.02 |
0.01 |
0.02 |
0.02 |
|
| Recrudescence |
0.45 |
0.58 |
0.42 |
0.72 |
0.41 |
0.58 |
0.44 |
0.72 |
|
| Parasites always above LoD |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.01 |
0.01 |
0.02 |
|
| Third, fourth, fifth and sixth dose missed |
All parasites cleared |
95.33 |
96.56 |
96.93 |
96.35 |
95.07 |
94.53 |
95.34 |
94.21 |
| Parasites below LoD |
0.01 |
0.01 |
0.03 |
0.02 |
0.01 |
0.01 |
0.01 |
0.00 |
|
| Recrudescence |
4.50 |
3.30 |
2.92 |
3.48 |
4.75 |
5.21 |
4.50 |
5.53 |
|
| Parasites always above LoD |
0.16 |
0.13 |
0.12 |
0.15 |
0.17 |
0.25 |
0.15 |
0.26 |
|
| Third, fourth, fifth and sixth dose delayed by 12 hours |
All parasites cleared |
99.83 |
99.82 |
99.83 |
99.81 |
99.83 |
99.83 |
99.85 |
99.82 |
| Parasites below LoD |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
|
| Recrudescence |
0.15 |
0.15 |
0.15 |
0.16 |
0.15 |
0.14 |
0.13 |
0.15 |
|
| Parasites always above LoD |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
0.01 |
|
| Increased IC50 by 50-fold for LF and 10-fold for AM and DHA |
All parasites cleared |
76.85 |
73.89 |
77.62 |
72.5 |
75.1 |
72.99 |
76.17 |
71.49 |
| Parasites below LoD |
0.02 |
0.02 |
0.02 |
0.00 |
0.02 |
0.01 |
0.01 |
0.01 |
|
| Recrudescence |
15.49 |
17.02 |
15.15 |
17.7 |
16.35 |
17.4 |
15.72 |
18.18 |
|
| Parasites always above LoD |
7.64 |
9.07 |
7.21 |
9.80 |
8.53 |
9.60 |
8.10 |
10.32 |
|
| Administered without food, i e, 50% lower dose for LF |
All parasites cleared |
99.82 |
99.81 |
99.83 |
99.81 |
99.82 |
99.8 |
99.85 |
99.75 |
| Parasites below LoD |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
0.01 |
0.02 |
|
| Recrudescence |
0.16 |
0.16 |
0.15 |
0.16 |
0.16 |
0.16 |
0.13 |
0.21 |
|
| Parasites always above LoD | 0.01 | 0.01 | 0.01 | 0.01 | 0.01 | 0.02 | 0.01 | 0.02 | |
DHA: dihydroartemisinin; IC50: Concentration producing half the desired effect; LoD: limit of detection (108 parasites).