Description
Habtamu Gebrie1, Mulat Yimer2, Animen Ayehu 2, Mogess Kassa3, Yonas Wuletaw 3, Hussien Mohammed3, Bokretsion Gidey3
1 Department of Medical Laboratory Science College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
2 Department of Medical Laboratory Science College of Medicine and Health Science, Bahir dar Univesity, Bahir dar, Ethiopia
3Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Corresponding author: Habtamu Gebrie
E-mail: habtamugebrie2012@gmail.com
Mobile: +251900391705
Acknowledgments
My sincere gratitude goes to my advisors Dr. Mulat Yimer, Mr. Animen Ayehu, and Mr. Bokretsion Gidey for their unwavering counsel, advice, helpful recommendations, and remarks. In addition, my gratitude also goes to the Ethiopian Public Health Institute for donating study drugs, equipment, reagents, and laboratory supplies, as well as to Bahir Dar University and Dilla University.
Abstract
Background: The majority of people in Ethiopia (60%) live in malaria risk area. Ethiopia has a "National Malaria Elimination Strategic Plan (NMESP 2021-2025)" to reduce the burden. The threat to efficient malaria control and elimination, however, is drug resistance. Hence, effective treatment is very important to combat the disease. However, malaria management in tropical Africa is severely hampered by the disease's resistance. This study assessed the therapeutic efficacy of chloroquine plus 14 days of primaquine on Plasmodium vivax infection based on parasitological, clinical, and haematological parameters.
Methods: A single-arm in vivo prospective antimalarial therapeutic efficacy study was conducted in Hamusit Health Centre, South Gondar, Ethiopia, from December 2022 to March 2023. A total of 100 study participants with Plasmodium vivax mono-infection who were above 6 months old were enrolled and monitored for adequate clinical and parasitological responses for 42 days. Purposive sampling was used for selecting the participants. A World Health Organization double-entry Excel sheet and SPSS version 25 software was used for Kaplan-Meier survival analysis, and analyze the data, respectively. A P-value of < 0.05 was considered a statistically significant association.
Results: Among 100 study participants, 92.6% (95% CI: 85.1%–96.4%)) were classified under adequate clinical and parasitological response and 7.4% (95% CI: 3.6%–14.9%) were classified under treatment failure. On day 3, 98% and 94% of study participants had clear fever and parasitemia, respectively, which show a strong association with one another (P = 0.033). At the baseline of the trial, 56 participants were anemic, but they improved significantly by the end of the study (P< 0.0001). The most frequent side effect on day 3 (5%) was head each.
Conclusions and Recommendations: With high clinical and parasitological responses, the current study's results show that Chloroquine plus Primaquine is still quite effective. This result confirms that this drug should remain Ethiopia's first-line treatment for P.vivax infection. These medications also offer quick relief from clinical symptoms, and their rate of parasite clearance was high. However, it is advised to regularly examine the effectiveness of the existing antimalarial and alternative medications.
Keywords: Chloroquine, Drug efficacy, Ethiopia, Primaquine, Plasmodium vivax
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