Archive \ Volume.14 2023 Issue 4

Treatment Failure of Artemether-Lumefantrine (Coartem) in Treating Malaria Among Adults. A cross-sectional Study

, , , , , , , , ,

Abstract

Treatment failure of Artemether-Lumefantrine drug in treating uncomplicated malaria is increasing in many endemic malaria countries. Tolerance, recrudescence, and resistance of plasmodium falciparum and plasmodium vivax parasites to the drug are increasing all over the world. We aimed to measure the treatment failure of antimalarial Artemether-Lumefantrine (Coartem) and it is contributing factors in uncomplicated malaria among adults in health centers. This study was a descriptive cross-sectional health-facility-based study conducted from the first of April to the end of June 2022 and included 166 malaria patients with positive test results for malaria visited health centers. 9.6% of malaria patients were not responding to coartem, 6.0% of them were plasmodium falciparum, 2.4% were plasmodium vivax, and 1.2 were mixed infections. Thirty-one percent of those not taking the drug with the fatty meal tested positive for malaria after two weeks of receiving coartem, and 25% of those not adherent to the treatment timetable have not cleared the parasite despite receiving coartem. The results showed that nearly one-third of the patients received Coartem without laboratory tests for malaria. Artemether-Lumefantrine is becoming less effective in the treatment of uncomplicated malaria among adults in Khartoum state, Sudan. Prospective studies are needed to assess the frequency of treatment failure and the contributing factors that assist in decreasing drug efficacy. We also encourage pharmacists not to give antimalarial treatment without a medical prescription and a positive test.


Downloads: 327
Views: 1746

How to cite:
Vancouver
Mohamed AS, Kheir MM, Noor SK, Elamin MO, Khan W, Natto HA, et al. Treatment Failure of Artemether-Lumefantrine (Coartem) in Treating Malaria Among Adults. A cross-sectional Study. Arch Pharm Pract. 2023;14(4):44-8. https://doi.org/10.51847/ZGQOpHeUaP
APA
Mohamed, A. S., Kheir, M. M., Noor, S. K., Elamin, M. O., Khan, W., Natto, H. A., Osman, A., Elamin, F., Alfaifi, M., & Badri, H. M. (2023). Treatment Failure of Artemether-Lumefantrine (Coartem) in Treating Malaria Among Adults. A cross-sectional Study. Archives of Pharmacy Practice, 14(4), 44-48. https://doi.org/10.51847/ZGQOpHeUaP

Download Citation
References

1.        World Health Organization (WHO). Malaria. 2020. Available from: www.who.int/health-topics/malaria#tab=tab_1.

2.        Federal Ministry of Health. Sudan Malaria Indicator Survey 2018. CNCDCD, Federal Ministry of Health, Khartoum, Sudan. 2018. Available from: https://web-archive.lshtm.ac.uk/www.linkmalaria.org/sites/link/files/content/country/profiles/Sudan%20PR%20risk%20map%20Final%20Report-2018.pdf

3.        White NJ. Antimalarial drug resistance. J Clin Invest. 2004;113(8):1084-92. doi:10.1172/JCI21682

4.        Federal Ministry of Health. National protocol for treatment of malaria 2017. Available from: https://reliefweb.int/report/sudan/sudan-malaria-diagnosis-and-treatment-protocol-2017

5.        Federal Ministry of Health, National malaria strategic plan 2014-2016. Available from: https://www.emro.who.int/sdn/programmes/malaria-sudan.html

6.        Adeel AA. Drug-resistant malaria in Sudan: a review of evidence and scenarios for the future. Sudan J Paediatr. 2012;12(1):8-20.

7.        Shibeshi MA, Kifle ZD, Atnafie SA. Antimalarial drug resistance and novel targets for antimalarial drug discovery. Infect Drug Resist. 2020;13:4047-60. doi:10.2147/IDR.S279433

8.        Popovici J, Pierce-Friedrich L, Kim S, Bin S, Run V, Lek D, et al. Recrudescence, reinfection, or relapse? A more rigorous framework to assess chloroquine efficacy for Plasmodium vivax malaria. J Infect Dis. 2019;219(2):315-22. doi:10.1093/infdis/jiy484

9.        John GK, Douglas NM, von Seidlein L, Nosten F, Baird JK, White NJ, et al. Primaquine radical cure of Plasmodium vivax: a critical review of the literature. Malar J. 2012;11:280. doi:10.1186/1475-2875-11-280

10.      World Health organization (WHO). Report on antimalarial drug efficacy, resistance and response: 10 years of surveillance (2010-2019). 2020. Available from: https://www.who.int/publications/i/item/9789240012813

11.      Kokwaro G, Mwai L, Nzila A. Artemether/lumefantrine in the treatment of uncomplicated falciparum malaria. Expert Opin Pharmacother. 2007;8(1):75-94. doi:10.1517/14656566.8.1.75

12.      Mahittikorn A, Masangkay FR, Kotepui KU, Milanez GD, Kotepui M. The high risk of malarial recurrence in patients with Plasmodium-mixed infection after treatment with antimalarial drugs: a systematic review and meta-analysis. Parasit Vectors. 2021;14(1):280. doi:10.1186/s13071-021-04792-5

13.      Kiaco K, Teixeira J, Machado M, Do Rosário V, Lopes D. Evaluation of artemether-lumefantrine efficacy in the treatment of uncomplicated malaria and its association with pfmdr1, pfatpase6 and K13-propeller polymorphisms in Luanda, Angola. Malar J. 2015;14:1-0. doi:10.1186/s12936-015-1018-3

14.      Nega D, Assefa A, Mohamed H, Solomon H, Woyessa A, Assefa Y, et al. Therapeutic efficacy of artemether-lumefantrine (Coartem®) in treating uncomplicated P. falciparum malaria in Metehara, Eastern Ethiopia: regulatory clinical study. Plos one. 2016;11(4):e0154618. doi:10.1371/journal.pone.0154618

15.      Rakotonandrasana DH, Tsukahara T, Yamamoto-Mitani N. Antimalarial drug prescribing by healthcare workers when malaria testing is negative: a qualitative study in Madagascar. Trop Med Health. 2018;46:1-9. doi:10.1186/s41182-018-0096-7

16.      Djimdé A, Lefèvre G. Understanding the pharmacokinetics of Coartem®. Malar J. 2009;8(1):1-8. doi:10.1186/1475-2875-8-S1-S4


 

 


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.