Short report: Increased risk of early vomiting among infants and young children treated with dihydroartemisinin-piperaquine compared with artemether-lumefantrine for uncomplicated malaria

Darren John Creek, Victor Bigira, Emmanuel Arinaitwe, Humphrey Wanzira, Abel Kakuru, Jordan W Tappero, Moses R K Kamya, Grant Dorsey, Taylor G Sandison

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Artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) are highly efficacious antimalarial therapies in Africa. However, there are limited data regarding the tolerability of these drugs in young children. We used data from a randomized control trial in rural Uganda to compare the risk of early vomiting (within one hour of dosing) for children 6?24 months of age randomized to receive DP (n = 240) or AL (n = 228) for treatment of uncomplicated malaria. Overall, DP was associated with a higher risk of early vomiting than AL (15.1 versus 7.1 ; P = 0.007). The increased risk of early vomiting with DP was only present among breastfeeding children (relative risk [RR] = 3.35, P = 0.001) compared with children who were not breastfeeding (RR = 1.03, P = 0.94). Age less than 18 months was a risk factor for early vomiting independent of treatment (RR = 3.27, P = 0.02). Our findings indicate that AL may be better tolerated than DP among young breastfeeding children treated for uncomplicated malaria.
Original languageEnglish
Pages (from-to)873 - 875
Number of pages3
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number4
Publication statusPublished - 2010

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