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Artemether-lumefantrine is the first registered, fixed, artemisinin-based combination treatment. Artemisinin derivatives are highly effective antimalarials with a favorable safety profile. Concerns remain over their potential neurotoxicity, although there has been no clinical evidence of this in humans. In animals (rats, dogs, and monkeys) artemether, a derivative of artemisinin is associated with an unusual toxicity pattern in specific brain nuclei involving the auditory and vestibular pathways. A recent report from Mozambique described a small but significant and irreversible hearing loss in patients exposed to artemether-lumefantrine. To explore this issue, we conducted a case-control study using tympanometry, audiometry and auditory brain-stem responses. We assessed 68 subjects who had been treated with artemether-lumefantrine within the previous five years and 68 age- and sex-matched controls living in the malarious region along the Thailand-Myanmar border. There were no differences in the test results between cases and controls. There was no neurophysiologic evidence of auditory brainstem toxicity that could be attributed to artemether-lumefantrine in this study population.

Original publication

DOI

10.4269/ajtmh.2006.74.211

Type

Journal article

Journal

The American journal of tropical medicine and hygiene

Publication Date

02/2006

Volume

74

Pages

211 - 214

Addresses

Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand. wec1@cdc.gov

Keywords

Humans, Malaria, Hearing Loss, Ethanolamines, Artemisinins, Fluorenes, Antimalarials, Acoustic Impedance Tests, Audiometry, Treatment Outcome, Drug Therapy, Combination, Case-Control Studies, Evoked Potentials, Auditory, Brain Stem, Adolescent, Adult, Aged, Middle Aged, Child, Female, Male