{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:31:49Z","timestamp":1790937109442,"version":"4.1.0"},"reference-count":49,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S0950268820003167_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>The resistance of <jats:italic>Plasmodium falciparum<\/jats:italic> to antimalarial drugs remains a major impairment in the treatment and eradication of malaria globally. Following the introduction of artemisinin-based combination therapy (ACT), there have been reports of delayed parasite clearance. In Kenya, artemether\u2013lumefantrine (AL) is the recommended first-line treatment of uncomplicated malaria. This study sought to assess the efficacy of AL after a decade of use as the preferred method of managing malarial infections in Kenya. We assessed clinical and parasitological responses of children under 5 years between May and November 2015 in Chulaimbo sub-County, Kisumu, Kenya. Patients aged between 6 and 60 months with uncomplicated <jats:italic>P. falciparum<\/jats:italic> mono-infection, confirmed through microscopy, were enrolled in the study. The patients were admitted at the facility for 3 days, treated with a standard dose of AL, and then put under observation for the next 28 days for the assessment of clinical and parasitological responses. Of the 90 patients enrolled, 14 were lost to follow-up while 76 were followed through to the end of the study period. Seventy-five patients (98.7%) cleared the parasitaemia within a period of 48 h while one patient (1.3%) cleared on day 3. There was 100% adequate clinical and parasitological response. All the patients cleared the parasites on day 3 and there were no re-infections observed during the stated follow-up period. This study, therefore, concludes that AL is highly efficacious in clearing <jats:italic>P. falciparum<\/jats:italic> parasites in children aged \u22656 and \u226460 months. The study, however, underscores the need for continued monitoring of the drug to forestall both gradual ineffectiveness and possible resistance to the drug in all target users.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s0950268820003167","type":"journal-article","created":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T10:02:32Z","timestamp":1609840952000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy of artemisinin\u2013lumefantrine for treatment of uncomplicated malaria after more than a decade of its use in Kenya"],"prefix":"10.1017","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3480-9372","authenticated-orcid":false,"given":"Gabriel","family":"Kishoyian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliud N. M.","family":"Njagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George O.","family":"Orinda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis T.","family":"Kimani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Thiongo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damaris","family":"Matoke-Muhia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,1,5]]},"reference":[{"key":"S0950268820003167_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-9-299"},{"key":"S0950268820003167_ref11","first-page":"152","article-title":"Temporal trends in prevalence of Plasmodium falciparum drug resistance alleles over two decades of changing antimalarial policy in coastal Kenya","volume":"4","author":"Okombo","year":"2014","journal-title":"International Journal for Parasitology: Drugs and Drug Resistance"},{"key":"S0950268820003167_ref3","doi-asserted-by":"crossref","unstructured":"3. Ishengoma, DS (2019) Efficacy and safety of artemether-lumefantrine for the treatment of uncomplicated malaria and prevalence of Pfk13 and Pfmdr1 polymorphisms after a decade of using artemisinin-based combination therapy in mainland Tanzania. Malaria Journal 18, 88.","DOI":"10.1186\/s12936-019-2730-1"},{"key":"S0950268820003167_ref14","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.44.4.991-996.2000"},{"key":"S0950268820003167_ref27","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a025619"},{"key":"S0950268820003167_ref6","volume-title":"Artemisinin and Artemisinin-Based Combination Therapy Resistance: Status Report","year":"2016"},{"key":"S0950268820003167_ref44","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-015-0826-9"},{"key":"S0950268820003167_ref48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0154618"},{"key":"S0950268820003167_ref8","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/S1473-3099(13)70252-4","article-title":"Novel phenotypic assays for the detection of artemisinin-resistant Plasmodium falciparum malaria in Cambodia: in-vitro and ex-vivo drug-response studies","volume":"13","author":"Witkowski","year":"2013","journal-title":"The Lancet Infectious Diseases"},{"key":"S0950268820003167_ref10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/0035-9203(77)90213-9","article-title":"Chloroquine resistant Plasmodium falciparum and malaria in Africa","volume":"71","author":"Olatunde","year":"1977","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"},{"key":"S0950268820003167_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-018-2494-z"},{"key":"S0950268820003167_ref20","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1186\/s13071-019-3547-z","article-title":"Malaria smear positivity among Kenyan children peaks at intermediate temperatures as predicted by ecological models","volume":"12","author":"Shah","year":"2019","journal-title":"Parasites and Vectors"},{"key":"S0950268820003167_ref31","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-018-2524-x"},{"key":"S0950268820003167_ref46","doi-asserted-by":"publisher","DOI":"10.1051\/parasite\/2018021"},{"key":"S0950268820003167_ref2","volume-title":"Antimicrobial Resistance and Primary Health Care: Brief","year":"2018"},{"key":"S0950268820003167_ref47","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-11-176"},{"key":"S0950268820003167_ref24","volume-title":"Guidelines for the Treatment of Malaria","year":"2015"},{"key":"S0950268820003167_ref39","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-018-2396-0"},{"key":"S0950268820003167_ref19","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1093\/femsre\/fuw037","article-title":"The clinical impact of artemisinin resistance in Southeast Asia and the potential future spread","volume":"41","author":"Woodrow","year":"2017","journal-title":"FEMS Microbiology Review"},{"key":"S0950268820003167_ref42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0176004"},{"key":"S0950268820003167_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkz098"},{"key":"S0950268820003167_ref43","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.15-0007"},{"key":"S0950268820003167_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-8-106"},{"key":"S0950268820003167_ref7","unstructured":"7. 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e27"}}