Evaluation of Efficacy of Co-artemisinin in the Treatment of Plasmodium falciparum Malaria in Gombe State, Nigeria

Abstract

Aim: To evaluate the potency and efficacy of co-artemisinin brands used in the treatment of uncomplicated Plasmodium falciparum malaria in Gombe State North-Eastern Nigeria. Materials and Methods: A total of 185 patients with malaria aged between 5-60 years attending Federal Teaching Hospital Gombe were recruited for the study between April to October, 2014. All patients were weighed and administered with one of the four study drugs for three days under the supervision of a medical staff. Blood samples were collected in an EDTA (Ethylene diamine tetra acetic acid) bottles before and during treatment and both thick and thin films were made for parasitaemia estimation. The PCR was used to distinguish recrudescence from new infection in case of treatment failure. Nested PCR was conducted to compare the genetic polymorphism of Plasmodium falciparum genes. PCR products were resolved by electrophoresis on ethidium bromide stained 1.5% Agarose. Results and Conclusion: Arthemether Lumefantrine and Dihydroartemisinin piperaquine recorded 100% cure rate while Artesunate sulfadoxine-pyrimethemin and Artesunate Amodiaquine recorded a cure rates of 91.4% and 90.5% respectively after polymerase chain reaction (PCR) correction. There was no significant difference between the drugs in terms of antiplasmodial activities (p = 0.780). A total of 15 out of 185 patients came down with symptom similar to that of malaria, 7 of 15 (46.7%) shows similarities in genotyping in pre and post treatment infection (reinfection) and 8 of 15 (53.3%) shows no similarities in the genotype from pre and post treatment infection. Statistically there was no significant difference between pre and post PCR genotyping (p = 0.203).