Malaria Cases Treated with Artemether/Lumefantrine in Japanese Travelers

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  • KUTSUNA Satoshi
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • KOBAYASHI Taiichiro
    Disease Control and Prevention Center, National Center for Global Health and Medicine Division of AIDS Clinical Center, National Center for Global Health and Medicine
  • KATO Yasuyuki
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • FUJIYA Yoshihiro
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • MAWATARI Momoko
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • UJIIE Mugen
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • TAKESHITA Nozomi
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • HAYAKAWA Kayoko
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • KANAGAWA Shuzo
    Disease Control and Prevention Center, National Center for Global Health and Medicine
  • MIZUNO Yasutaka
    Disease Control and Prevention Center, National Center for Global Health and Medicine Department of Infection Control and Prevention, Tokyo Medical University Hospital
  • KANO Shigeyuki
    Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine
  • OHMAGARI Norio
    Disease Control and Prevention Center, National Center for Global Health and Medicine

Bibliographic Information

Other Title
  • アーテメター・ルメファントリン合剤の日本人における使用経験
  • アーテメター ・ ルメファントリンゴウザイ ノ ニホンジン ニ オケル シヨウ ケイケン

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Description

Artemisinin-based combination therapy (ACT) has been the standard treatment for uncomplicated malaria. Although not licensed in Japan, artemether/lumefantrine (AL), one type of ACT, has been administered to patients with malaria since 2002 by the Research Group on Chemotherapy of Tropical Diseases. Herein, we reviewed malaria cases treated with AL in Japanese travelers. A retrospective study was conducted at the National Center for Global Health and Medicine from October 2005 to March 2013. There were 19 malaria patients treated with AL, and 10 falciparum malaria patients treated with AL only. In these 10 patients treated with AL only, the median time of fever clearance was 25.0 hours (range : 14-66 hours), and the median time of parasite clearance was 36.0 hours (range : 16-62 hours). There was a positive correlation between parasitemia and time from the start of therapy to the disappearance of the parasites. Parasitemia was higher (4.05％vs. 0.24％；p＝0.044) and parasite clearance time was longer (55.5 hours vs. 31.5 hours ; p＝0.044) in the cases of recrudescence than non-recrudescence, respectively. Three of the 19 malaria patients showed recrudescence of malaria after treatment with AL. The reason that treatment failure was more frequently observed in this study than in previous reports may be related to poor absorption of lumefantrine owing to gastrointestinal symptoms, insufficiently ingested fatty foods, or high parasitemia on admission. The World Health Organization recommends that intravenous antimalarials should be administered in cases of severe malaria ; however, this is not applicable in Japan. Further studies are needed to distinguish patients with malaria who are treatable with ACT from those who should be treated initially with other intravenous antimalarials.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 88 (6), 833-839, 2014

    The Japanese Association for Infectious Diseases

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