Therapeutic efficacy of artemether-lumefantrine for treatment of uncomplicated <i>plasmodium falciparum</i> malaria in Enugu, Nigeria

Abstract

Purpose: To review current therapeutic efficacy of artemether-lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in patients in Enugu State, Nigeria.Methods: One hundred and fifty four malaria patients from three different Local Government Areas (LGA) of Enugu State, southeastern Nigeria, that fulfilled the inclusion criteria were recruited through rapid diagnostic testing and blood film microscopy. The patients received a 3-day complete dose of AL treatment; they were monitored and 3 mL of blood in EDTA bottle was sampled on days 0, 3, 7, 14 and 28. The samples were evaluated by real-time polymerase chain reaction (RT-PCR) for identification and quantification of Plasmodium falciparum. Clinical and parasitological responses were recorded and analyzed statistically.Results: There was significant decrease (p > 0.002) in patient’s temperature (from 40 to 37 ºC) from day 0 to day 28. There was significant decrease (p < 0.001) between parasite mean density on day 0 and the values on days 3,7,14 and 28, with high prevalence of delayed parasite clearance. There was no early treatment failure, while 4 (3.4 %), 30 (25.4 %), and 84 (75.1 %) had late clinical failure, late parasitological response and adequate clinical and parasitological response, respectively.Conclusion: Artemether – lumefantrine combination therapy reduced fever in malaria patients but failed to totally clear parasitemia density, indicating its reduced therapeutic efficacy in Enugu State, Nigeria.