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The resistance of Plasmodium falciparum to antimalarial drugs remains a major impairment in the treatment and eradication of malaria globally. Following the introduction of artemisinin-based combination therapy (ACT), there have been reports of delayed parasite clearance. In Kenya, artemether–lumefantrine (AL) is the recommended first-line treatment of uncomplicated malaria. This study sought to assess the efficacy of AL after a decade of use as the preferred method of managing malarial infections in Kenya. We assessed clinical and parasitological responses of children under 5 years between May and November 2015 in Chulaimbo sub-County, Kisumu, Kenya. Patients aged between 6 and 60 months with uncomplicated P. falciparum mono-infection, confirmed through microscopy, were enrolled in the study. The patients were admitted at the facility for 3 days, treated with a standard dose of AL, and then put under observation for the next 28 days for the assessment of clinical and parasitological responses. Of the 90 patients enrolled, 14 were lost to follow-up while 76 were followed through to the end of the study period. Seventy-five patients (98.7%) cleared the parasitaemia within a period of 48 h while one patient (1.3%) cleared on day 3. There was 100% adequate clinical and parasitological response. All the patients cleared the parasites on day 3 and there were no re-infections observed during the stated follow-up period. This study, therefore, concludes that AL is highly efficacious in clearing P. falciparum parasites in children aged ≥6 and ≤60 months. The study, however, underscores the need for continued monitoring of the drug to forestall both gradual ineffectiveness and possible resistance to the drug in all target users.
Some of the upheavals, such as the Eurasian outbreak of Black Death of the fourteenth century and the introduction of Old World diseases to the Americas in the sixteenth and seventeenth centuries, had such broad historical consequences that they seem to stand categorically outside of earlier human experience. The common cold was almost certainly among the first of the Old World viruses to infect individuals in the Caribbean. Beginning in the middle of the seventeenth century, a second wave of infections from the Old World crossed the Atlantic and opened a new chapter in the global integration of infectious disease such as falciparum malaria and yellow fever. The third wave of infections from seventeenth century into middle of the nineteenth century is bubonic plague confined for centuries to the expanses of Eurasia, breaking out periodically. In Northern Africa and Eurasia, the disease burden was substantially different, because many of the tropical diseases could not be transmitted in other ecological zones.
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