Abstract |
Animal studies have demonstrated artemisinin brain stem toxicity with auditory centres being especially affected; there has, to date, been no evidence of such toxicity with oral artemisinins in humans. Subjects working at a construction site in Mozambique had audiometric assessments taken on joining and leaving the project. Subjects with uncomplicated malarias received co-artemether ( artemether-lumefantrine) (n = 150) while age-, gender-, weight- and race-matched controls (n = 150) neither suffered malaria nor received antimalarial therapy. Hearing thresholds were measured at predefined frequencies in treated subjects and controls. Subjects receiving co-artemether had a significantly greater heating loss than controls at all frequencies except 250 Hz and 500 Hz (P values ranging from <0.001 to 0.04, Mann-Whitney U). Mean changes at the different frequencies in subjects ranged from -6.50 dB (95% CI -8.19 to -4.81) [at 1kHz frequency] to -0.07 dB (95% CI -2.19 to 2.05) [at 6 kHz frequency]. Mean changes in the control group ranged from -4.20 dB (95% CI -5.97 to -2.43) [at 1 kHz frequency] to +2.7 dB (95% CI -0.93 to 4.47) [at 6 kHz frequency]. Treatment of uncomplicated malaria with co-artemether is associated with hearing loss, possibly from synergy between potentially ototoxic agents in combination. The safety and neurotoxicity of artemesinins and other endoperoxides needs to be more fully evaluated.
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Authors | Stephen Toovey, Andrew Jamieson |
Journal | Transactions of the Royal Society of Tropical Medicine and Hygiene
(Trans R Soc Trop Med Hyg)
Vol. 98
Issue 5
Pg. 261-7; discussion 268-9
(May 2004)
ISSN: 0035-9203 [Print] England |
PMID | 15109547
(Publication Type: Journal Article)
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Chemical References |
- Antimalarials
- Artemether, Lumefantrine Drug Combination
- Artemisinins
- Drug Combinations
- Ethanolamines
- Fluorenes
- Sesquiterpenes
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Topics |
- Adult
- Aged
- Antimalarials
(adverse effects)
- Artemether, Lumefantrine Drug Combination
- Artemisinins
(adverse effects)
- Audiometry
- Drug Combinations
- Ethanolamines
- Female
- Fluorenes
(adverse effects)
- Hearing Disorders
(chemically induced, diagnosis)
- Humans
- Malaria, Falciparum
(drug therapy)
- Male
- Middle Aged
- Sesquiterpenes
(adverse effects)
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