Assessment of the Effectiveness of Different Brands of Artemisinin – Based Combination Therapy Among Patients with Uncomplicated Falciparum Malaria

Malaria is a mosquito-borne parasitic disease that still remains a threat to public health, especially to children, pregnant women, elderly and the immunosuppressed individuals. Of the five Plasmodium species affecting humans, Plasmodium falciparum has been considered as the most prevalent and notorious parasite in Africa. This study was aimed at evaluating the susceptibility of P. falciparum to three brands of Artemisinin Combination Therapies (ACTs) in subjects with uncomplicated falciparum malaria. Microscopic technique was employed to determine the treatment outcome, using 28 days World Health Organization (WHO) protocol. Similarly, to differentiate new malaria infection from recrudescence, subjects with positive parastaemia from day 7 onward were genotyped by nested Polymerase Chain Reaction (nPCR) using merozoite surface protein 2 (MSP2) genetic markers. From the results obtained, cure rates of the 3 brands of ACTs tested were not significantly different (p>0.05). The 28 days PCR-adjusted cure rate revealed patients treated with Dihydroartemisinin-piperaquine (D-P) (97.2%) had significantly ((p<0.05)) lower risk of recrudescence compared to patients treated with Artemether-lumefantrine (A-L) (95.1%) and Artesunate-amodiaquine (A-A) (91.7%). Conclusively, P. falciparum is susceptible to all the three ACTs. However, D-P is more efficacious than A-L and A-A, thus, reaffirming its supremacy in the treatment of uncomplicated falciparum malaria.