Monitoring the efficacy of Coartem® for uncomplicated falciparum malaria in Selekleka town, Tigray Region, Northern Ethiopia

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Addis Ababa University


Drug resistance is the most serious problem in achieving control of malaria. The spread of Plasmodium falciparum resistance to almost all available affordable mono-therapy, in many malaria endemic regions, is a serious impediment on malaria control. The current WHO recommendation for treatment of uncomplicated P. falciparum malaria is the use of Coartem®, an artemisinin based combination therapy (ACT). Coartem® (20mg artemether and 120mg lumefantrine) is an artemisinin based tablet that provides effective antimalarial treatment against uncomplicated falciparum malaria in many parts of the world, including sub-saharan Africa. The present study was conducted to monitor the efficacy of this drug in patients 6 months with uncomplicated falciparum malaria in Selekleka town, Northwestern Tigray, Ethiopia. A total of 98 study participants, microscopically confirmed for P. falciparum mono-infection, were included in the study. Majority of the study participants were adults above 15 years (87.8%). At enrollment, 65 (66%) patients were febrile (T 37.5ºC) and the overall parasite mean density was 22,679. Six doses of Coartem were given over 3 days, two doses each day, on D0, D1, and D2; with a follow up on D3, D7, D14, D21 and D28. The clinical and parasitological conditions of the patients were assessed at each visit. The level of hemoglobin in the study participants was determined by using hemocue reader. 89 (90.8%) patients completed the 28-day follow-up while 9 (9.2%) patients were excluded from the study because of loss-to-follow-up and withdrawal of consent. The ACT treatment rapidly cleared parasitaemia and fever by D2 and complete gametocyte clearance was obtained on D21. Significant (p= 0.05) hemoglobin recovery was observed among patients with adequate clinical and parasitological response. No severe adverse side-effects, clinical failures or parasitological failures were observed among these patients. Overall, the 28-day clinical and parasitological cure rate was 100%. Coartem, therefore, was efficacious for the treatment of uncomplicated falciparum malaria in Selekleka town. However, the reported increasing trend in P. falciparum prevalence since 2007/8 in Selekleka, despite free availability of Coartem and ITN coverage, needs further investigation on the efficacy of the malaria measures in use. Key words: Malaria, P. falciparum, Coartem, Selekleka town, Cure rate, Hemoglobin recovery, Adverse effects



Malaria, P. falciparum, Coartem, Selekleka town, Cure rate, Hemoglobin recovery, Adverse effects