In-vivo Efficacy Profiles of Plasmodium falciparum to Artemether- Lumefantrine, the Recommended First-Line Treatment of Uncomplicated Malaria in Kisii County Kenya

Abstract

Aims: This study was aimed at evaluating the In-vivo sensitivity patterns of Plasmodium. falciparum to Artemether-Lumefantrine in Kisii County, Kenya. Study Design: Single-arm, cross sectional, prospective study. Place and Duration of the Study: This study was carried out in Kisii County, Kenya in 2021, during the months of February to June. Methodology: Multi-stage random sampling was used. Participants suspected to be having malaria were recruited, confirmed for P. falciparum and treated with Arthemeter- Lumefantrine (AL). The participants were followed for 28 days. Efficacy of the AL treatment was assessed as per the WHO criteria (2007). Data was analyzed using the chi square (χ2), Fisher’s exact test and two-sample t test. Results: Follow-up was completed for 84% (231.0± 0.23) participants. The study reported Earlier Treatment Failure (ETF) of 27 (11.7 %), Late Clinical Failure (LCF) of 20 (8.7 %), Late Parasitological Failure (LPF) of 11(3.9 %), and Adequate Clinical and Parasitological Failure (ACPR) of 173 (75.0 %). Fever was not detected among 1.45% (3.98 ± 0.25) during enrollment. The treatment outcome with AL was first noted at day 3 of the follow up with 15.2 ± 0.33 of the patients testing negative for P. falciparum. By day 28, 94% (217.14 ± 0.72) of the patients were cleared of parasitemia. Age and weight were statistically significant factors influencing the treatment outcomes at, Age, p=0.005 and Weight, p=0.001. Conclusions: Artemether-Lumefantrine (AL) remains efficacious in the study area, however more studies using molecular methods needs to be conducted.