Right combination of malaria drugs?

Children in Uganda recover from malaria faster when taking an herb-based combination therapy than when given standard drugs, solidifying the herbal drugs as frontline treatments for malaria in Africa.

Artemisinin is made from the leaves of the Chinese wormwood shrub (SN: 2/7/04, p. 94), and the drugs artesunate and artemether are derivatives known to kill the parasites that cause malaria.

Researchers monitored the health of 601 children for up to 19 months. During that time, 329 came down with malaria caused by the protozoan Plasmodium falciparum. The scientists randomly assigned some of these kids to get one of the artemisinin derivatives in combination with longer-acting drugs. Others received pills combining sulfadoxine and pyrimethamine, an old, inexpensive therapy still used extensively in Africa (SN: 11/11/06, p. 307).

Only 7 percent of children getting the artemether combination failed to recover within a month, compared with 17 percent of those getting the artesunate combination and 26 percent receiving the sulfadoxine-pyrimethamine pills, Philip J. Rosenthal of the University of California, San Francisco and his colleagues report in the May 23/30 Journal of the American Medical Association. In light of earlier results, the researchers are confident that the artemisinins are the greater contributors to the combinations’ success.

Unlike the case for chloroquine and most other antimalarials, “there’s probably no resistance to the artemisinins in Africa,” Rosenthal says. “We used chloroquine for 50 years. … Now, we’re clearly settling in with the artemisinin combination therapies as our new answer.”