{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:18:09Z","timestamp":1781828289698,"version":"3.54.5"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Artemisinin-based combination therapy (ACT) has been effective in the supervised treatment of uncomplicated malaria in Ghana. Since ACT usage is primarily unsupervised, this study aimed to determine the effectiveness of artemether\u2013lumefantrine (AL) for treating malaria patients in two transmission settings in Ghana.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Eighty-four individuals with uncomplicated <jats:italic>Plasmodium falciparum<\/jats:italic> malaria were recruited from Lekma Hospital (LH) in Accra (low-transmission area; N\u2009=\u200928), southern Ghana, and King\u2019s Medical Centre (KMC) in Kumbungu (high-transmission area; N\u2009=\u200956), northern Ghana. Participants were followed up for 28\u00a0days after unsupervised treatment with AL. The presence of asexual parasites was determined by microscopic examination of Giemsa-stained blood smears. <jats:italic>Plasmodium<\/jats:italic> species identification was confirmed using species-specific primers targeting the <jats:italic>18S rRNA<\/jats:italic> gene<jats:italic>.<\/jats:italic> Parasite recrudescence or reinfection was determined by genotyping the <jats:italic>Pfmsp<\/jats:italic> 1 and <jats:italic>Pfmsp<\/jats:italic> 2 genes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>After AL treatment, 3.6% (2\/56) of the patients from KMC were parasitaemic on day 3 compared to none from the LH patients. One patient from KMC with delayed parasite clearance on day 3 remained parasite-positive by microscopy on day 7 but was parasite-free by day 14. While none of the patients from LH experienced parasite recurrence during the 28-day follow-up, three and two patients from KMC had recurrent parasitaemia on days 21 and 28, respectively. Percentage reduction in parasite densities from day 1, 2, and 3 for participants from the KMC was 63.2%, 89.5%, and 84.5%. Parasite densities for participants from the LH reduced from 98.2%, 99.8% on day 1, and 2 to 100% on day 3. The 28-day cumulative incidence rate of treatment failure for KMC was 12.8% (95% confidence interval: 1.9\u201323.7%), while the per-protocol effectiveness of AL in KMC was 89.47%. All recurrent cases were assigned to recrudescence after parasite genotyping by <jats:italic>Pfmsp<\/jats:italic> 1 and <jats:italic>Pfmsp<\/jats:italic> 2.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>While AL is efficacious in treating uncomplicated malaria in Ghana, when taken under unsupervised conditions, it showed an 89.4% PCR-corrected cure rate in northern Ghana, which is slightly below the WHO-defined threshold.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-024-04850-0","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T18:05:13Z","timestamp":1707156313000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of artemether\u2013lumefantrine for treating uncomplicated malaria in low- and high-transmission areas of Ghana"],"prefix":"10.1186","volume":"23","author":[{"given":"Mawusi Adepa","family":"Mawuli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda Eva","family":"Amoah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwang","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neils Ben","family":"Quashie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaw Asare","family":"Afrane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"4850_CR1","volume-title":"World malaria report 2021","author":"WHO","year":"2021","unstructured":"WHO. 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Written informed consent was obtained from the participants or the guardians of minors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors consent to the publication of this research paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Aside from acknowledging the source of funding for this work, the authors declare that there are no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"40"}}