In Vivo Comparative Evaluation of Effects of Artemeter-Lumefantrine, Sulphadoxine-Pyrimetamine and Halofantrine on G6PD Activities, Haemoglobin Concentration and Malaria Parasite Clearance Rate in Malaria Infected Adults

Abstract

Background: The use of antimalaria combination therapy especially regimens containing an artemisin-based compound has been recommended as a good first-line treatment for malaria by WHO. However, limited reports exist on the effects of the ACT and other antimalarial drugs on some vital biological parameters such as G6PD activity and haemoglobin concentration. In this study, we investigated the effects of Artemeter-Lumefantrine, sulphadoxine-pyrimetamine combination therapies and Halofantrine monotherapy on G6PD activity, Haemoglobin level and parasite clearance rate in malaria-infected adults treated with the drugs in Enugu, Nigeria. Methodology: Forty malaria-infected adults aged between 20 and 30 years were used. The subjects were divided into four groups (A, B, C and D). The groups A, B and C were given Artemeter-Lumefantrine, sulphadoxine-pyrimetamine and halofantrine respectively, while group D was a control group (malaria-positive control). Blood samples of the subjects were collected through venepuncture at baseline (Day 0) and after treatment on Day 4, for comparative analysis of G6PD activity, haemoglobin concentration and parasite clearance for each group. Results: The result of this study showed that sulphadoxine-pyrimetamine significantly (p<0.05) lowered haemoglobin concentration as compared with Halofantrine, Artemeter-lumefantrine and control. The haemoglobin concentration of the last three groups did not show any significant difference (p>0.05) between each other. The G6PD activity of the group treated with sulphadoxine-pyrimetamine was significantly (p<0.05) higher as compared with that treated with Artemeter-lumefantrine but non-significant (p>0.05) as compared with halofantrine and control. Parasite clearance rate was significantly (p<0.05) highest with the Halofantrine group (76%, p< 0.05) while Sulphadoxine-pyrimetamine had the lowest (52%) parasite clearance. Conclusion: This study therefore indicated that antimalaria drugs as well as malaria parasite could cause a reduction in haemoglobin concentration with sulphadoxine-pyrimetamine causing significant (p<0.05) increase in G-6-PD activity.

Keywords: Antimalarials, Artemether-Lumefantrine, G6PD, sulphadoxine-pyrimetamine, Parasite clearance, Halofantrine, Haemoglobin concentration