Comparative Evaluation of the Effects of Artemisinin-based Combination Therapy and Amodiaquine Monotherapy in G6PD Activity, Fasting Glucose Level and Parasite Clearance Rate in Malaria-infected Adults in Abakaliki, Nigeria.

Abstract

Background: Antimalaria combination therapy with regimen containing an artemisinin-based compound has been recommended as a gold standard and first-line treatment for malaria by WHO. Studies have also proven the effectiveness of Artemisinin-based Combination Therapy (ACT) in the treatment of uncomplicated Plasmoduim falciparum and delaying the emergence of drug resistance. However, limited reports exist on the effects of ACT on some vital biochemical parameters such as glucose-6-phosphate dehydrogenase (G6PD) and blood glucose concentration. This study therefore investigates and compares the effects of Artesunate-Amodiaquine combination therapy and Amodiaquine monotherapy on G6PD activity, fasting blood glucose level and parasite clearance rate in malaria-infected adults in Abakaliki, Nigeria. Methodology: Twenty adults aged between 20 and 30 years were used for the study. The patients were divided into two groups-A and B of 10 individuals each. Group A was given Artesunate-Amodiaquine (AS-AQ) while group B was given Amodiaquine (AQ). Blood samples were collected from each individual at baseline (Day 0) and after drug treatment (Day 4) for the comparative analysis of G6PD activity, fasting blood glucose level and parasite clearance rate. Result: There was an increase in G6PD activity after drug treatment in the two groups but the increase was not statistically significant. Glucose levels decreased after treatment in both groups but the decrease was also insignificant. There was a significant (P<0.001) difference in malaria parasite density of both groups after drug administration. The percentage parasite clearance of AS-AQ treated group and the AQ treated group were 67% and 47% respectively. Conclusion: There were no significant differences in the AS-AQ and AQ effects on the G6PD activity and fasting glucose level. In contrast, AS-AQ therapy indicated higher parasitic clearance rate compared to the AQ therapy. This further proves that Artemisinin-based Combination Therapy (ACT) is more effective than monotherapy in the treatment of malaria.

Keywords: Artemisinin- Amodiaquine, Combination therapy, Amodiaquine, Parasite clearance, G6pd, Glucose.