Author(s)

L. C. Chukwu^1*, P. U. Agbasi², P. C. Unekwe³, F. N. Oguwike⁴

¹Department of Pharmacology, Chukwuemeka Odumegwu Ojukwu University, Igbariam, Nigeria.
²Department of Prosthetics and Orthotics, Federal University of Technology, Owerri, Nigeria.
³Department of Pharmacology, Nnamdi Azikiwe University, Awka, Nigeria.
⁴Department of Physiology, Chukwuemeka Odimegwu Ojukwu University, Igbariam, Nigeria.

Background: The World Health Organization adopted Artenisinin based combination therapy (ACT) for the treatment of uncomplicated malaria in endemic regions. The efficacy of ACT in malaria treatment must have prompted this choice. There’s need to protect the ACT from plasmodial resistance. Hence, clinical scaling up of ACT program is needed. This entails continued assessment, monitoring and evaluation of the effectiveness of component drugs in endemic areas. Purpose: This study revisited the evaluation of the effectiveness of artemether-lumefantrine combination (ALC) in the treatment of uncomplicated malaria in Elele, Nigeria. Method: The study was conducted in Elele, a malaria endemic area in Rivers State, Nigeria. This was a facility based descriptive, cross sectional study at Madonna University Teaching Hospital (MUTH) Elele using simple sampling technique. Qualitative and quantitative data were collected. 100 patients who consented to the study were recruited in the outpatient clinic using semi structured questionnaires as part of study instrument. Inclusion criteria were having a body temperature of ≥37.5°C, symptoms of malaria, positive parasitemia, non ingestion of antimalarial in the past 2 weeks, etc. MUTH ethics committee gave ethical clearance. Patient recruitment following consent commenced with their symptoms and signs recorded at presentation while disappearance of the same was determined following drug ingestion on days 2/4/6/8/10 and 14. The data gotten was analyzed by tallying the responses to get the frequencies using SPSS 16.0 version and Microsoft excel tools. The student t-test was used to calculate the P-value, values < 0.05 was considered statistically significant. Results: Most of the patients knew mosquitoes as the mode of malaria transmission (70%). The ACT is known and used by these patients: artesunate/amodiaquine: 41 (41%); artesunate/lumefantrine: 40 (40%); artesunate/sulphadoxine-pyrimethamine: 38(38%); artesunate/mefloquine: 20 (20%). Fever was the predominant presenting symptom, 92% followed by body weakness (90%); headache (85%); malaise (80%); loss of appetite (80%); nausea (72%); vomiting (70%); abdominal pains (50%). Others were: pallor (30%); hepatomegally (20%); splenomegally (20%); chills (20%); rigor (20%). By day 10 of therapy, fever, vomiting and abdominal pains had disappeared in all patients, some patients still had mild: body weakness 40%; headache 2%; malaise 24%; loss of appetite 20% and nausea 10%. Day 14 recorded no symptoms in all patients. There was effective clinical response (ECR) by day 14. Conclusion: This study hereby reaffirms the efficacy and effectiveness of Artemether-lumefantrine Combination in the treatment of uncomplicated malaria in Elele, Nigeria. The need to fill the existing knowledge gap of monitoring and evaluation of ACT in rural endemic areas has been done by this study.

Uncomplicated Malaria, Fever, Effectiveness, Artemisinin Based Combination, Elele

Chukwu, L. , Agbasi, P. , Unekwe, P. and Oguwike, F. (2019) Revisiting the Evaluation of the Effectiveness of Artemether-Lumefantrine Combination in the Treatment of Uncomplicated Malaria in Elele, a Malaria Endemic Area in Rivers State Nigeria. Journal of Biosciences and Medicines, 7, 59-72. doi: 10.4236/jbm.2019.76005.