A Randomized Clinical Trial Comparing Artesunate/Amodiaquine and Coartem in Treatment of Uncomplicated Malaria in Pregnancy in Mulago Hospital
DOI:
https://doi.org/10.53555/nnmhs.v5i2.599Keywords:
RANDOMIZED, CLINICAL, COMPARING, ARTESUNATE/AMODIAQUINE, COARTEM, TREATMENT, UNCOMPLICATED, MALARIA, PREGNANCY, MULAGO, HOSPITAL.Abstract
BACKGROUND: The therapeutic efficacy and safety of artesunate plus amodiaquine and artemether/lumefantrine were assessed in Mulago hospital, Kampala, Uganda, an area with high levels of Plasmodium falciparum resistance to chloroquine and sulphadoxine-pyrimethamine. MATERIALS AND METHODS: A total of 369 pregnant mothers beyond the first trimester (>12 weeks) and less than 37 weeks of gestation with signs and symptoms of malaria were screened for malaria parasites. Of these, 109 had uncomplicated malaria infection with parasite density 200 to 200,000 parasites/?L and were enrolled following informed consent. Eligible pregnant mothers were randomly assigned to receive either a 3-day course of Coartem (Artemether 20mgs/ Lumefantrine 200mgs) 4 tablets twice a day 12 hourly on days 0, 1 and 2; or Artesunate/Amodiaquine on days 0, 1 and 2 (4tablets of Artesunate plus 4 tablets of Amodiaquine once a day). The Coartem arm had 55 participants while the Artesunat/Amodiaquine (DUACT) arm had 54 participants. Patients were followed up with clinical and laboratory assessments until day 14. RESULTS: The clinical and parasitological response between Coarten (artemether-lumefantrine) and artesunate+amodiaquine (DUACT) in the treatment of uncomplicated malaria in pregnant mothers were statistically similar. The side effects for the two treatment arms were also statistically similar. CONCLUSION: Artemether-lumenfantrine (coartem) and artesunate plus amodiaquine (DUACT) had high and similar cure rates and tolerability among pregnant mothers in Mulago Hospital, Uganda.
References
i WHO world malaria report 2018
ii WHO malaria treatment guidelines 2015
iii Africa Malaria Report, 2003 – The World Health Organisation
iv Steketee RW, Nahlen BL, Parise ME, Menedez C. The burden of malaria in pregnancy in malaria-endemic areas. American journal of tropical medicine and hygiene 2001; 64(1, 2) S: 28-35.
v Centre for Disease Control and Prevention (CDC)
vi Menendez C1
, Ordi J, Ismail MR, Ventura PJ, Aponte JJ, Kahigwa E, Font F, Alonso PL: The impact of placental malaria on gestational age and birth weight.
vii Malaria Prev. new - Regional Office for Africa - World Health https://www.afro.who.int/sites/default/files/2017.../malaria_in_pregnancy_092004
viii Richard W. Steketee, Bernard L. Nahlen, Monica E. Parise, and Clara Menendez: The Burden of Malaria in Pregnancy in Malaria-Endemic Areas
ix Tanzania Health Research Bulletin (2007), Vol. 9, No. 3: Placental malaria in Owerri, Imo State, south-eastern Nigeria
x Effect of pregnancy on exposure to malaria mosquitoes. – NCBI - S Lindsay - 2000
xi WHO | Intermittent preventive treatment in pregnancy (IPTp) https://www.who.int/malaria/areas/preventive_therapies/pregnancy/en/
xii Malaria Treatment and Management: https:emedicine.mediscape.com
xiii Centres for Disease Control and Prevention. Updated CDC Recommendations for Using ArtemetherLumefantrine for the Treatment of Uncomplicated Malaria in Pregnant Women in the United States;
https://www.cdc.gov/mmwr/volumes/67/wr/mm6714a4.htm?s_cid=mm6714a4_e#contribAff. April 2018; Accessed: April 13, 2018.)
xiv Wernsdorfer, McGregor L. Edinburgh: Churchhill Livingstone; 1988:781- 814. Shute GT: The microscopic diagnosis of malaria. In Principle and practice of malariology
xv Steketee RW et al. the problem of malaria and malaria control in pregnancy in sub-Saharan Africa. American journal of tropical medicine and hygien, 1996, 55 (1 suppl), 2-7.
xvi McGready R, Cho, T, Keo, NK, et al. Artemisinin antimalarials in pregnancy: a prospective treatment study of 539 episodes of Multidrug-resistant Plasmodium falciparum. Clin Infect Dis 2001;33:2009.
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