Therapeutic efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in four malaria endemic states of India

Autor: Anil Kumar Verma, Shyam S Tekam, Neeraj Dhingra, Prem L. Mandavi, Maria Dorina Bustos, Anup Singh Tidgam, Prakash Tiwari, Himanshu Jayswar, Aparup Das, Sweta Mishra, Hari Barman, Praveen K. Bharti, Sri Krishna, Neeru Singh, Manas Malik, Mukund S Diggikar, Pascal Ringwald, Naresh Yerane, Brij M Varun, Sunil Kumar Singh, Eva-Maria Christophel, Suyesh Shrivastava, Chintaman R Tembhurne, Surendra Jhariya, Avdhesh Kumar, Madan Mohan Pradhan, Khemraj Sonwani, Man Mohan Shukla, Kali Prasad Behera, Anup K Vishwakarma, Shashikant Tiwari, Sushrikanta Khandai, Roop Kumari, Pradeep Tiwari, Sher S Khasotiya
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Male
Artemether/lumefantrine
Endemic Diseases
RC955-962
Infectious and parasitic diseases
RC109-216
Drug resistance
chemistry.chemical_compound
0302 clinical medicine
Arctic medicine. Tropical medicine
Medicine
Artemether-lumefantrine
Malaria
Falciparum
Child
biology
Middle Aged
Infectious Diseases
Child
Preschool
Female
medicine.drug
Adult
medicine.medical_specialty
Adolescent
030231 tropical medicine
030106 microbiology
Plasmodium falciparum
India
03 medical and health sciences
Antimalarials
Young Adult
Internal medicine
parasitic diseases
Humans
business.industry
Public health
Research
Artemether
Lumefantrine Drug Combination
Infant
biology.organism_classification
medicine.disease
Therapeutic efficacy
Malaria
chemistry
Parasitology
Artesunate
Tropical medicine
business
Zdroj: Malaria Journal
Malaria Journal, Vol 20, Iss 1, Pp 1-10 (2021)
ISSN: 1475-2875
Popis: Background Malaria is a major public health problem in India and accounts for about 88% of malaria burden in South-East Asia. India alone accounted for 2% of total malaria cases globally. Anti-malarial drug resistance is one of the major problems for malaria control and elimination programme. Artemether-lumefantrine (AL) is the first-line treatment of uncomplicated Plasmodium falciparum in north eastern states of India since 2013 after confirming the resistance against sulfadoxine-pyrimethamine. In the present study, therapeutic efficacy of artemether-lumefantrine and k13 polymorphism was assessed in uncomplicated P. falciparum malaria. Methods This study was conducted at four community health centres located in Koraput district of Odisha, Bastar district of Chhattisgarh, Balaghat district of Madhya Pradesh and Gondia district of Maharashtra state. Patients with uncomplicated P. falciparum malaria were administered with fixed dose combination (6 doses) of artemether-lumefantrine for 3 days and clinical and parasitological response was recorded up to 28 days as per World Health Organization protocol. Nucleotide sequencing of msp1 and msp2 gene was performed to differentiate between recrudescence and reinfection. Amplification and sequencing of k13 propeller gene region covering codon 450–680 was also carried out to identify the polymorphism. Results A total 376 malaria patients who fulfilled the enrolment criteria as well as consented for the study were enrolled. Total 356 patients were followed up successfully up to 28 days. Overall, the adequate clinical and parasitological response was 98.9% and 99.4% with and without PCR correction respectively. No case of early treatment failure was observed. However, four cases (1.1%) of late parasitological failure were found from the Bastar district of Chhattisgarh. Genotyping of msp1 and msp2 confirmed 2 cases each of recrudescence and reinfection, respectively. Mutation analysis of k13 propeller gene showed one non-synonymous mutation Q613H in one isolate from Bastar. Conclusions The study results showed that artemether-lumefantrine is highly effective in the treatment of uncomplicated P. falciparum malaria among all age groups. No functional mutation in k13 was found in the study area. The data from this study will be helpful in implementation of artemether-lumefantrine in case of treatment failure by artesunate plus sulfadoxine-pyrimethamine.
Databáze: OpenAIRE
Externí odkaz: