Open comparative efficacy of some artemisinin-based combinations for treatment of acute uncomplicated plasmodium falciparum malaria in Ilorin Nigeria

Abstract

Widespread resistance of Plasmodium falciparum to chloroquine and sulfadoxinepyrimethamine has prompted the federal government of Nigeria, in line with WHO recommendations to adopt artemisinin-based combinations as first-line treatment of acute uncomplicated Plasmodium falciparum malaria. We evaluated 3 artemisinin-based combinations available in the Nigerian market to determine their efficacy and tolerability. Adequate clinical and parasitological response (ACPR) was comparable between artemetherlumefantrine (A-L) and artesunate-amodiaquine (AS-AQ) groups (92.8% v 91.2%, p = 0.79), both combinations being significantly more efficacious than artesunate-sulfadoxinepyrimethamine (AS-SP) group (A-L v AS-SP 92.8% v 69%; p = 0.005); (AS-AQ v AS-SP 91.2% v 69%; p = 0.018). Drug-related adverse events were significantly higher among the AS-AQ group compared to other treatment combinations (p = 0.004). We conclude that A-L and ASAQ have high comparative cure rates among patients evaluated in ilorin, Nigeria. Tolerability concern should play an important consideration when prescribing AS-AQ especially among adult patients.