Table 1 Effects of artemether-lumefantrine on gametocyte carriage/clearance - summary of key conclusions*

Makanga et al.[30]

Pooled analysis of 7 studies conducted between 1996-2007

Pooled population: 647 adults and 1,332 children

AL showed high cure rates and rapid resolution of parasitaemia, fever, and gametocytaemia in adults and children

Gbotosho et al.[28]

Anti-malarial efficacy studies in Ibadan, southwestern Nigeria

2,585 children aged 0.5-15 years

AL reduced the rate of gametocyte carriage in children with acute falciparum infections at presentation and shortened the duration of male gametocyte carriage after treatment

Assefa et al.[37]

28-day therapeutic efficacy study in Kersa District, Addis Ababa

90 adults and children

The study showed a rapid decline in gametocytes with treatment

The clearance rate was more rapid than that found in other studies, which reported the presence of gametocytes up to day 14 and beyond

John et al.[47]

Kipsamoite (7 villages) and Kapsisiywa (9 villages) in the Nandi Hills district of Kenya

8,094 adults and children

Treatment with AL (combined with IRS) reduced gametocyte carriage and density in children compared with the period prior to its implementation

Hatz et al.[54]

Open-label, non-comparative study in Europe and non-endemic regions of Colombia

165 non-immune adult travellers

Treatment with AL was effective in clearing gametocytes by end of study in non-immune adults

Juma et al.[53]

Randomized, controlled, open-label study comparing AL tablets with AL paediatric suspension in Western Kenya

245 children

AL tablets and the 3-dose suspension effectively cleared gametocytes in these children

Makanga et al. [64]

Pooled analysis of 8 studies to compare 6-dose with 4-dose AL regimen

544 children

The 6-dose regimen is associated with a more rapid clearance of parasites and a faster and more sustained reduction in gametocyte carriage than the 4-dose regimen

4 studies in Africa

4 studies in Thailand

Chanda et al.[62]

Open label, one-arm prospective evaluation of paediatric suspension of AL in Zambia

91 children (<10 kg)

AL paediatric suspension was associated with a significant and rapid reduction in gametocytes

Barnes et al.[68]

Open-label in vivo study in KwaZulu-Natal province, South Africa, to determine therapeutic efficacy of a 6-dose regimen of AL

100 adults

AL contributed to a marked and sustained decrease in malaria cases, admissions, and deaths, by greatly improving clinical and parasitological cure rates and reducing gametocyte carriage

Lefèvre et al.[70]

Randomized, open-label, parallel group 4-week trial in Thailand

219 adults and children with multidrug-resistant P. falciparum malaria

AL rapidly cleared gametocytes in multidrug-resistant P. falciparum malaria