Comparative efficacy of five brands of Arthemeter Combination Therapy (ACTS) purchased in Ekiti State, Nigeria

Abstract

Malaria is one of the most severe public health problems and a leading cause of morbidity and mortality where children and pregnant women are the most affected groups. This may be as a result of resistant of malaria parasites which are mostly traceable to drug adulteration. In this study, Plasmodium berghei NK65, a rodent malaria parasite was used as a model organism to simulate human malaria parasite. The efficacy of five brands of arthemeter combination therapies (ACTs) purchased from pharmacy stores in Ekiti state were evaluated. The drugs were coded Art-Ar, Art-Ph, Art-Ki, Art- Na, and Art-Gy respectively. Twenty-one mice were constituted into seven different groups of three mice. Each mouse was inoculated inter-peritoneally with Plasmodium berghei NK65 and left for 7days for the parasite to manifest. The prepared drug solution was administered on five of the seven groups orally for 10 days, while the remaining groups were used as the positive and the negative control groups. One of the control groups was given chloroquine (positive) and the other normal saline (negative). The antimalarial efficacy of the drugs (ACTs) was determined by examining their influence on the increase or decrease in the number of parasites (parasitemia level). Giemsa stained thin blood smears from the tails were used to assess parasitemia level and the parasites clearance rate. Results show that the average parasite clearance rates were 14.1, 40.6, 25.3, 44.9 and 27.9 for Arthemeter coded as Art-Ar, Art-Ph, Art-Ki, Art- Na and Art-Gy respectively. All the brands significantly cleared all the parasites within 7-9days of the treatment, which shows that adulterated Arthemeter is not presently in the community studied. Therefore, arthemeter combination therapy is recommended as a drug of choice for the treatment of malaria fever in Ekiti State.