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Malaria Research and Treatment
Volume 2014, Article ID 263674, 20 pages
http://dx.doi.org/10.1155/2014/263674
Review Article

Does the Use of Dihydroartemisinin-Piperaquine in Treating Patients with Uncomplicated falciparum Malaria Reduce the Risk for Recurrent New falciparum Infection More Than Artemether-Lumefantrine?

1AngloGold Ashanti Hospital, P.O. Box 10, Obuasi, Ghana
2Florence Nightingale School of Nursing and Midwifery, King’s College London, London SE1 8WA, UK

Received 8 February 2014; Revised 4 May 2014; Accepted 18 May 2014; Published 19 June 2014

Academic Editor: Donatella Taramelli

Copyright © 2014 Wisdom Akpaloo and Edward Purssell. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Malaria contributes significantly to the global disease burden. The World Health Organization recommended the use of artemisinin-based combination therapies (ACTs) for treatment of uncomplicated falciparum malaria a decade ago in response to problems of drug resistance. This review compared two of the ACTs—Dihydroartemisinin-Piperaquine (DP) and Artemether-Lumefantrine (AL) to provide evidence which one has the ability to offer superior posttreatment prophylaxis at 28 and 42 days posttreatment. Four databases (MEDLINE, EMBASE, Cochrane Database and Global Health) were searched on June 2, 2013 and a total of seven randomized controlled trials conducted in sub-Sahara Africa were included. Results involving 2, 340 participants indicates that reduction in risk for recurrent new falciparum infections (RNIs) was 79% at day 28 in favour of DP [RR, 0.21; 95% CI: 0.14 to 0.32, ], and at day 42 was 44% favouring DP [RR, 0.56; 95% CI: 0.34 to 0.90; ]. No significant difference was seen in treatment failure rates between the two drugs at days 28 and 42. It is concluded that use of DP offers superior posttreatment prophylaxis compared to AL in the study areas. Hence DP can help reduce malaria cases in such areas more than AL.