Artemether-lumefantrine and primaquine for mixed Plasmodium falciparum and ovale malaria

Abstract

Aim: To present a case of uncomplicated mixed Plasmodium falciparum and ovale malaria requiring treatment with artemether-lumefantrine and primaquine. Clinical features: A 40-year-old female presented with a mixed infection of uncomplicated P. falciparum and ovale. Treatment was commenced with oral quinine sulphate 600 mg, 8-hourly which was changed to artemether-lumefantrine and primaquine. A glucose-6-phosphate-dehydrogenase test revealed deficiency, necessitating an alteration of the primaquine regimen. Discussion: Malaria infections are often initially treated with quinine if the infective species is not known or if the infection is mixed. Oral quinine remains useful in the treatment of uncomplicated P. falciparum malaria, however the six-dose regimen of artemether-lumefantrine is an effective alternative. Conclusion: This case highlights the benefits of artemether-lumefantrine for mixed-uncomplicated malaria and the use of primaquine for eradication of liver stages for P. ovale infections.