Comparison of malaria parasite clearance times during quinine and artesunate administration for cerebral Malaria in Blantyre, Malaw
Loading...
Date
2021-07-01
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Malaria which is caused by Plasmodium species is one of the most important human parasitic diseases. In recent years, preceding 2014, the most severe form of the disease, cerebral malaria, was recommended by World Health Organization (WHO) to be treated with quinine, but due to its increased side effects over the recently discovered drug, artemisinin derivatives, WHO
substituted quinine as first line treatment with artemisinin derivatives in combination with a
long-acting drug such as lumefantrine, piperaquine, amodiaquine, mefloquine, pyronaridine or
sulfadoxine-pyrimethamine. Delay in parasite clearance time in treated patients is the main
characteristic of parasite resistance to a particular antimalarial drug. Malaria parasites have
already shown resistance to the currently recommended artemisinin derivatives in South East
Asia, a development that prompted WHO to recommend periodic monitoring of the drug's
effectiveness in endemic countries. Malawian children admitted with cerebral malaria (CM)
between 2010 and 2019 in a long-standing pathogenesis study at Blantyre’s main referral
hospital, Queen Elizabeth Central Hospital (QECH) were retrospectively sampled at admission
and every six hours until two consecutive malaria smears were negative. This was done to
monitor parasite clearance times across those years. Yearly average clearance time was
compared to 2014, the year when artesunate replaced quinine as first-line therapy for CM in
Malawian hospitals. Parasite clearance time was shown to be slower during the quinine era
compared to the artesunate, an indication that artesunate is superior to quinine. There was no
increase in clearance times from the onset of artesunate as first-line therapy, showing that the
current recommended anti-malarial drug is still effective.
Description
Keywords
Biomedical technology, Laboratory technology