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Study on the Efficacy and Safety of Artemether/Lumefantrine in the Treatment of Uncomplicated Plasmodium Falciparum Malaria amongst Children in Kano

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Study on the Efficacy and Safety of Artemether/Lumefantrine in the Treatment of Uncomplicated Plasmodium Falciparum Malaria amongst Children in Kano.

Abstract

Globally, malaria is a major health concern because it causes high morbidity and  mortality particularly in children under 5 years because of their low immunity.

The development of resistance to chloroquine and sulphodoxine/pyrimethamine in many  parts of the world has further worsened the disease.

In  2001, WHO  recommended  the use of artemisinin combination therapy for the treatment of uncomplicated Plasmodium falciparum malaria in countries experiencing resistance to chloroquine and other antimalarial monotherapies.

In 2005, Nigeria made a shift in the policy of treatment and adopted WHO Artemisinin Combination Therapy policy for the treatment of uncomplicated Plasmodium falciparum malaria.

The aim of the study was to assess the therapeutic efficacy and safety of the  artemether/lumefantrine supplied by the Kano  State Government for the treatment of uncomplicated Plasmodium falciparum malaria following an observed increase in patients requiring retreatment.

It was a prospective evaluation of clinical and parasitological responses to directly observed treatment of uncomplicated Plasmodium falciparum malaria using artemether/lumefantrine.

Patients of ages 6-59 months numbering 73 who met the inclusion criteria were enrolled into the study after a written informed consent by their parents or guardians.

Introduction

Background of Study

Malaria is one of the major health problems in the tropics and affect about 3.3billion people globally in 104 countries (WHO, 2012). It is estimated that 207 million cases of malaria occurred in 2012 globally and 90% of the cases were reported in the African continent (WHO, 2013).

The number of deaths due to malaria globally was estimated to be 627,000 in 2012, 90% of this cases were reported in the African continent (WHO, 2013).

Nigeria, the Democratic Republic of Congo (DRC) and India accounts for 40% of all estimated cases, while Nigeria and the Democratic Republic of Congo (DRC) account for 40% of estimated total malaria deaths globally (WHO, 2012).

In 2012, malaria killed an estimated 482,000 children worldwide, i.e. 1300 children died every day or one child almost every minute. In Nigeria, it is estimated that more than 300,000 children aged less than 5 years die annually from malaria annually (WHO, 2010).

The main cause of malaria in Nigeria is Plasmodium falciparum, accounting for 98% malaria cases (FMOH, 2005). Uncomplicated malaria occurs in the majority of those affected, and is the form of illness which presents with symptoms such as fever, headache, muscle pain, anaemia, enlarged spleen, vomiting and sometimes diarrhoea.

In children, there could also be rapid breathing and convulsion. Uncomplicated Falciparum malaria does not involve prostration, hypoglycaemia haemoglobinuria, jaundice, renal failure, abnormal bleeding, shock, acidosis, severe anemia, impaired consciousness, multiple convulsions and respiratory distress (WHO, 2000). Chloroquine was the drug of choice in the past for the treatment of uncomplicated malaria.

References

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Ashley, M., V., Ahmed, S., I. and Stefen, H., I. (2008). Malaria Parasite Pre-erythrocytic State infection: Gliding and Hiding. Cell Host microbe, 4 (3):209-218.

Ashley, E. A., Stepvieska, K., Lindegerdh, N., Annergerg, A., Kham, A. Brockman, P., and Nosten, F. (2007). How much fat is necessary to optimize Lumefantrine Oral Bioavailability? Tropical Medicine and International Health, 12: 195-200.

Assefa, A.,Kassa, M., Tadesa, G.,Mohamed, H., Animut, A. and Mengesha, T.(2010). Therapeutic Efficacy of Artemether/Lumefantrine (Coartem) Against Plasmodium falciparum in Kersa, South West Ethiopia, Parasites and Vectors, 3:1.

Bakshi, R., Hermeling-Fritz, I., Gathmann, I. Alteri,E.,(2000). An Integrated Assessment of The Clinical Safety of Artemether/lumefantrine: A New Oral Fix Dose Combination Antimalarial Drug. Transactions of the Royal Society of Tropical Medicine and. Hygiene, 9:419-424

Barnes, K.I., Chanda, P.,Barnaba, G. (2009). Impact of Large Scale Deployment of Artemether/lumefantrine on the Malaria Disease Burden in Africa: Case Studies of South Africa, Zambia, and Ethiopia. Malaria Journal, (8).58.doi: 10.1186/1475-2875-8-S1-S8.

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