Summary

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• Artesunate is indicated for the initial treatment of severe malaria in both adults and children, showing high efficacy in reducing symptoms and parasite load. However, it requires a follow-up with an appropriate oral antimalarial regimen to complete the treatment effectively.
• Nine studies provided insights into Artesunate's safety and effectiveness compared to other antimalarials.
• Comparisons between combinations such as Artesunate + Sulfadoxine-Pyrimethamine (AS+SP) suggest evolving efficacy that requires continuous surveillance and potential adjustments to malaria treatment strategies.
• In comparison with other Artemisinin Combination Therapies (ACTs), Pyronaridine-Artesunate may have equal or superior efficacy but carries an increased risk of mild drug-induced liver injury, indicating a specific safety consideration against its effectiveness.
• The combination of Artesunate and Primaquine for the radical cure of vivax malaria was found safe; however, concerns revolve around haemolysis due to Primaquine primarily in patients with G6PD deficiency rather than direct issues associated with Artesunate itself.
• For Seasonal Malaria Chemoprevention (SMC), especially among children under 5 years old extending to those ≤15 years old in areas experiencing high transmission rates, preventive strategies involving Artesunate could significantly benefit.