Artemether-Lumefantrine Combination for Non-Comorbid Falciparum Malaria: A Clinico-Parasitological Efficacy Study http://www.doi.org/10.26538/tjnpr/v6i10.26

Main Article Content

Chinelo K. Ezejiegu
Angus N. Oli
Chinwendu N. Ezomike
Christian C. Uba
Uchenna C. Ogwaluonye
Charles O. Esimone

Abstract

With the emergence of chloroquine resistance, Artemisinin Combination Therapy use was advocated for by the WHO and this has been fully adopted by Nigeria for treating malaria due to falciparum infection. The present study focused on assessing the clinico-parasitological efficacy of Artemether-Lumefantrine, following the need to monitor the efficacy of ACTs as a tool for early detection of resistance. The WHO 2009 protocols for studying the efficacy of antimalarial agents were adopted. The study enrolled 75 adult patients living within Anambra state, diagnosed with falciparum malaria and met the inclusion criteria of the study. Patients were administered 6 doses of Artemether-Lumefantrine and monitored for 28days for any therapy failure or adverse events. Early treatment failure of 15.95% was recorded. Although ACPR, cure rate and parasite clearance were above 70% (76.8%, 97.10% and 80.4% respectively). The study also showed clearance of asexual stage (gametocytes) by day 3 of treatment. There was a satisfactory efficacy and safety of AL thus supporting the continued use of AL as the drug of choice for non-complicated malaria in the studied population.

Downloads

Download data is not yet available.

Article Details

How to Cite
K. Ezejiegu, C., N. Oli, A., N. Ezomike, C., C. Uba, C., C. Ogwaluonye, U., & O. Esimone, C. (2022). Artemether-Lumefantrine Combination for Non-Comorbid Falciparum Malaria: A Clinico-Parasitological Efficacy Study: http://www.doi.org/10.26538/tjnpr/v6i10.26. Tropical Journal of Natural Product Research (TJNPR), 6(10), 1715-1718. https://tjnpr.org/index.php/home/article/view/1262
Section
Articles

How to Cite

K. Ezejiegu, C., N. Oli, A., N. Ezomike, C., C. Uba, C., C. Ogwaluonye, U., & O. Esimone, C. (2022). Artemether-Lumefantrine Combination for Non-Comorbid Falciparum Malaria: A Clinico-Parasitological Efficacy Study: http://www.doi.org/10.26538/tjnpr/v6i10.26. Tropical Journal of Natural Product Research (TJNPR), 6(10), 1715-1718. https://tjnpr.org/index.php/home/article/view/1262

References

World Malaria Report 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. http://apps.who.int/iris/bitstream/handle/10665/275867/978924 1565653-eng.pdf Accessed 12 Jan 2020

Snow RW, Sartorius B, Kyalo D, Maina J, Amratia P, Mundia CW, Bejon P, Noor AM. The prevalence of Plasmodium falciparum in sub-Saharan Africa since 1900. Nature. 2017; 550(7677):515-518.

World Health Organization. (2015). Guidelines for the treatment of malaria, 3rd ed. World Health Organization. https://apps.who.int/iris/handle/10665/162441 Accessed 1st April 2022

Noedl H, Se Y, Sriwichai S, Schaecher K, Teja-Isavadharm P, Smith B, Rutvisuttinunt W, Bethell D, Surasri S, Fukuda MM, Socheat D, Chan Thap L. Artemisinin resistance in Cambodia: a clinical trial designed to address an emerging problem in Southeast Asia. Clin Infect Dis. 2010; 51(11):e82-9.

Bethell D, Se Y, Lon C, Tyner S, Saunders D, Sriwichai S, Darapiseth S, Teja-Isavadharm P, Khemawoot P, Schaecher K, Ruttvisutinunt W, Lin J, Kuntawungin W, Gosi P, Timmermans A, Smith B, Socheat D, Fukuda MM. Artesunate dose escalation for the treatment of uncomplicated malaria in a region of reported artemisinin resistance: a randomized clinical trial. PLoS One. 2011; 6(5):e19283.

Phyo AP, Nkhoma S, Stepniewska K, Ashley EA, Nair S, McGready R, ler Moo C, Al-Saai S, Dondorp AM, Lwin KM, Singhasivanon P, Day NP, White NJ, Anderson TJ, Nosten F. Emergence of artemisinin-resistant malaria on the western border of Thailand: a longitudinal study. Lancet. 2012; 379(9830):1960-6.

Uwimana A, Umulisa N, Venkatesan M, Svigel SS, Zhou Z, Munyaneza T, Habimana RM, Rucogoza A, Moriarty LF, Sandford R, Piercefield E, Goldman I, Ezema B, Talundzic E, Pacheco MA, Escalante AA, Ngamije D, Mangala JN, Kabera M, Munguti K, Murindahabi M, Brieger W, Musanabaganwa C, Mutesa L, Udhayakumar V, Mbituyumuremyi A, Halsey ES, Lucchi NW. Association of Plasmodium falciparum kelch13 R561H genotypes with delayed parasite clearance in Rwanda: an open-label, single-arm, multicentre, therapeutic efficacy study. Lancet Infect Dis. 2021; 21(8):1120-1128.

Maniga JN, Aliero AA, Ibrahim N, Okech MA, Mack MC. Plasmodium falciparum malaria clinical and parasitological outcomes after in-vivo Artemether-Lumefantrine (AL) treatment at Bushenyi District Uganda. Int J Trop Dis Health. 2018; 8:10-8.

Ebong C, Sserwanga A, Namuganga JF, Kapisi J, Mpimbaza A, Gonahasa S, Asua V, Gudoi S, Kigozi R, Tibenderana J, Bwanika JB. Efficacy and safety of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum malaria and prevalence of molecular markers associated with artemisinin and partner drug resistance in Uganda. Malar J. 2021 Dec;20(1):1-12.

Oguche S, Okafor HU, Watila I, Meremikwu M, Agomo P, Ogala W, Agomo C, Ntadom G, Banjo O, Okuboyejo T, Ogunrinde G, Odey F, Aina O, Sofola T, Sowunmi A. Efficacy of artemisinin-based combination treatments of uncomplicated falciparum malaria in under-five-year-old Nigerian children. Am J Trop Med Hyg. 2014; 91(5):925-935.

World Health Organization, 2009. Methods for surveillance of antimalarial drug efficacy. https://www.who.int/docs/default- source/documents/publications/gmp/methods-for-surveillance- of-antimalarial-drug-efficacy.pdf?sfvrsn=29076702_2 Accessed on April 1, 2022

Saito M, Mansoor R, Kennon K, Anvikar AR, Ashley EA, Chandramohan D, Cohee LM, D'Alessandro U, Genton B, Gilder ME, Juma E, Kalilani-Phiri L, Kuepfer I, Laufer MK, Lwin KM, Meshnick SR, Mosha D, Mwapasa V, Mwebaza N, Nambozi M, Ndiaye JA, Nosten F, Nyunt M, Ogutu B, Parikh S, Paw MK, Phyo AP, Pimanpanarak M, Piola P, Rijken MJ, Sriprawat K, Tagbor HK, Tarning J, Tinto H, Valéa I, Valecha N, White NJ, Wiladphaingern J, Stepniewska K, McGready R, Guérin PJ. Efficacy and tolerability of artemisinin-based and quinine-based treatments for uncomplicated falciparum malaria in pregnancy: a systematic review and individual patient data meta-analysis. Lancet Infect Dis. 2020; 20(8):943-952.

Smith SJ, Kamara ARY, Sahr F, Samai M, Swaray AS, Menard D, Warsame M. Efficacy of artemisinin-based combination therapies and prevalence of molecular markers associated with artemisinin, piperaquine and sulfadoxine-pyrimethamine resistance in Sierra Leone. Acta Trop. 2018; 185:363-370.

Warsame M, Hassan AH, Hassan AM, Arale AM, Jibril AM, Mohamud SA, Barrette A, Muse AY, Yusuf FE, Nada RA, Amran JG. Efficacy of artesunate + sulphadoxine/pyrimethamine and artemether + lumefantrine and dhfr and dhps mutations in Somalia: evidence for updating the malaria treatment policy. Trop Med Int Health. 2017; 22(4):415-422.

Sow D, Ndiaye JL, Sylla K, Ba MS, Tine RC, Faye B, Pene M, Ndiaye M, Seck A, Lo AC, Abiola A, Dieng Y, Gaye O. Evaluation of the efficacy and safety of three 2-drug combinations for the treatment of uncomplicated Plasmodium falciparum malaria in Senegal: artesunate-amodiaquine, dihydroartemisinin-piperaquine, and artemether-lumefantrine. Med Sante Trop. 2016; 26(1):45-50.

Dambe R, Sande J, Ali D, Chilima B, Dodoli W, Michelo C, Malenga G, Phiri KS. Monitoring the efficacy of artemether- lumefantrine for the treatment of uncomplicated malaria in Malawian children. Malar J. 2015; 14:175.

Ayogu EE, Ukwe CV, Nna EO. Therapeutic efficacy of artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Enugu, Nigeria. Trop J Pharmaceut Res. 2015; 14(8):1487-93.

Mwaiswelo R, Ngasala B, Jovel I, Aydin-Schmidt B, Gosling R, Premji Z, Mmbando B, Björkman A, Mårtensson A. Adding a single low-dose of primaquine (0.25 mg/kg) to artemether- lumefantrine did not compromise treatment outcome of uncomplicated Plasmodium falciparum malaria in Tanzania: a randomized, single-blinded clinical trial. Malar J. 2016 Dec;15(1):1-8.

Sowunmi A, Akano K, Ntadom G, Ayede AI, Ibironke FO, Aderoyeje T, Adewoye EO, Fatunmbi B, Oguche S, Okafor HU, Watila I, Meremikwu M, Agomo P, Ogala W, Agomo C, Folarin OA, Gbotosho GO, Happi CT. Therapeutic efficacy and effects of artemisinin-based combination treatments on uncomplicated Plasmodium falciparum malaria -associated anaemia in Nigerian children during seven years of adoption as first-line treatments. Infect Dis Poverty. 2017; 6(1):36.

Ebenebe JC, Ntadom G, Ambe J, Wammanda R, Jiya N, Finomo F, Emechebe G, Mokuolu O, Akano K, Agomo C, Folarin OA, Oguche S, Useh F, Oyibo W, Aderoyeje T, Abdulkadir M, Ezeigwe NM, Happi C, Sowunmi A, For The Antimalarial Therapeutic Efficacy Monitoring Group National Malaria Elimination Programme The Federal Ministry Of Health Abuja Nigeria. Efficacy of Artemisinin-Based Combination Treatments of Uncomplicated Falciparum Malaria in Under-Five-Year-Old Nigerian Children Ten Years Following Adoption as First-Line Antimalarials. Am J Trop Med Hyg. 2018; 99(3):649-664.

Kilonzi M, Minzi O, Mutagonda R, Sasi P, Kamuhabwa A, Aklillu E. Comparison of malaria treatment outcome of generic and innovator’s anti-malarial drugs containing artemether– lumefantrine combination in the management of uncomplicated malaria amongst Tanzanian children. Malar J. 2019 Dec;18(1):1-8.

Agarwal A, McMorrow M, Onyango P, Otieno K, Odero C, Williamson J, Kariuki S, Kachur SP, Slutsker L, Desai M. A randomized trial of artemether-lumefantrine and dihydroartemisinin-piperaquine in the treatment of uncomplicated malaria among children in western Kenya. Malar J. 2013; 12:254.

Ogutu BR, Onyango KO, Koskei N, Omondi EK, Ongecha JM, Otieno GA, Obonyo C, Otieno L, Eyase F, Johnson JD, Omollo R, Perkins DJ, Akhwale W, Juma E. Efficacy and safety of artemether-lumefantrine and dihydroartemisinin-piperaquine in the treatment of uncomplicated Plasmodium falciparum malaria in Kenyan children aged less than five years: results of an open- label, randomized, single-centre study. Malar J. 2014; 13:33.

Agede OA, Mokuolu OA, Falade CO. Evaluation of the Safety and Efficacy of Artemether-Lumefantrine and Dihydroartemisinin-Piperaquine for Treating Childhood Malaria in Ilorin, Nigeria. Archives of Basic and Applied Medicine. 2021; 9(2):125-34.