Extending the Duration of Artemether-Lumefantrine Treatment for Uncomplicated Plasmodium falciparum Malaria: Updated US Centers for Disease Control and Prevention Guidance Based on Review of Surveillance, Consultations, and Published Data
Clinical Infectious Diseases·
- DOI
- 10.1093/cid/ciag456
- PMID
- 42616037
- PMCID
- —
- OpenAlex
- W7203771166
- Study type
- Meta-analysis
- Publisher
- Oxford University Press (OUP)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The article provides evidence relevant to treatment policy for uncomplicated Plasmodium falciparum malaria among travelers in the United States. Its findings were reported as informing updated CDC guidance, but this summary does not independently assess that guidance or connect the article with a live surveillance signal.
Structured evidence summary
Research question
The article evaluates treatment-failure risk after artemether-lumefantrine or atovaquone-proguanil in travelers treated outside malaria-endemic settings and examines longer artemether-lumefantrine regimens for uncomplicated Plasmodium falciparum malaria.
Study design
The authors reviewed US malaria surveillance data, CDC clinical consultations, molecular resistance surveillance data, and published literature. They also conducted a meta-analysis and reviewed the efficacy and safety of artemether-lumefantrine courses longer than 3 days.
Population and setting
The evidence concerns travelers treated in nonendemic settings, with US CDC consultation records from November 2022 through October 2025. All reported treatment-failure cases had traveled to Africa, and 62% presented with severe malaria.
Main findings
CDC was consulted on 47 treatment failures: 40 after artemether-lumefantrine and 7 after atovaquone-proguanil. The pooled artemether-lumefantrine failure estimate was 7% for data from 2018 onward versus 4% for earlier data, without a statistically significant difference; longer regimens, especially 5 days, were reported as well tolerated and associated with higher lumefantrine exposure.
Public-health relevance
The article provides evidence relevant to treatment policy for uncomplicated Plasmodium falciparum malaria among travelers in the United States. Its findings were reported as informing updated CDC guidance, but this summary does not independently assess that guidance or connect the article with a live surveillance signal.
Important limitations
The summary is limited to the supplied single-article abstract and bibliographic metadata; the original paper is required for decision-grade assessment of study methods, data completeness, subgroup definitions, and limitations. The abstract also reports that the difference between the later and earlier pooled failure estimates was not statistically significant.
GIDS interpretation
The article is discoverable under malaria treatment, surveillance, and travel medicine, with a United States setting. It provides contextual literature evidence about treatment-failure review and regimen duration, without establishing or confirming a current surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 12 auditable classifier relationships to diseases, places, topics, and study design.