Abstract
Background and study aim: Despite the global priority given to malaria control and prevention, antimalarial resistance is a major factor that encourages persistence of malaria in developing countries. This prospective study sought to determine the antimalarial resistance pattern of P. falciparum isolated from infected pregnant women attending antenatal clinics at Kaduna state, Northern Nigeria. Materials and Methods: Between 16th February and 28th April, 2015, EDTA anticoagulated blood samples were collected from seventy nine pregnant women with plasmodiasis. Antimalarial susceptibility of chloroquine, artesunate, artemether and sulfadoxin-pyrimethamine (SP) against P falciparum was done using schizont maturation assay. Multidrug resistant plasmodiasis was defined by resistance to ≥ 3 antimalarial drugs. Results: Malaria parasites from the pregnant women exhibited the highest resistance against chloroquine, 85 (Session [UserIDID].1%) followed by Artemether, 30 (8.5%) then sulfadoxin-pyrimethamine, 29 (8.2%) and least resistant to artesunate, 28 (7.9%). The occurrence rate of multidrug resistance was 40.5%. There was no significant association between occurrence of multidrug resistance and malaria parasitaemia (p=0.092). Seventy five, 94.8% of the P. falciparum infected subjects exhibit resistant to at least one antimalarial. Antimalarial resistance was highest in women with severe malaria 20 (80.0%), followed by those with moderate malaria, 15 (62.5%) and least in those with mild malaria, 4 (13.3%). There was significant association between occurrence of antimalarial resistance and densities of malaria parasitaemia (p=0.0125). Conclusion: Considering the high degree of antimalarial resistance reported from this study, there will be challenges in eradicating malaria in this environment. These findings necessitate the need for regular surveillance for resistant P. falciparum and evaluation of more effective alternative drug (s).
Highlights
Malaria is a major public health challenge in sub-Saharan Africa
intermittent preventive treatment (IPT)-SP should be used in regions with SP resistance prevalence less than 30% [9]. This prospective study sought to determine the antimalarial resistance pattern of P. falciparum isolated from infected pregnant women attending antenatal clinics at Kaduna state, Northern Nigeria
Malaria parasites from pregnant women exhibited the highest resistance against chloroquine, 75(94.9%) and least resistant to artesunate, 28 (35.4%)
Summary
Malaria is a major public health challenge in sub-Saharan Africa. In 2015, there were an estimated 214 million cases and 438,000 deaths due to malaria globally with Nigeria accounting for 25% of these [1]. Despite the public health priority given to malaria, in recent time, the parasite has developed resistance to most of the commonly available prophylactic and therapeutic antimalarial agents [1,2]. The main objective of antimalarial sensitivity testing is to evaluate the parasite (s) sensitivity to increasing antimalarial dosages. Despite the global priority given to malaria control and prevention, antimalarial resistance is a major factor that encourages persistence of malaria in developing countries. This prospective study sought to determine the antimalarial resistance pattern of P. falciparum isolated from infected pregnant women attending antenatal clinics at Kaduna state, Northern Nigeria
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