Monitoring The Efficacy Of Coartem For Uncomplicated Falciparum Malaria In Selekleka Town Tigray Region Northern Ethiopia

Drug resistance is the most serious problem in achieving control of malaria. The spread ofrnPlasmodium falciparum resistance to almost all available affordable mono-therapy, in manyrnmalaria endemic regions, is a serious impediment on malaria control. The current WHOrnrecommendation for treatment of uncomplicated P. falciparum malaria is the use of Coartem®,rnan artemisinin based combination therapy (ACT). Coartem® (20mg artemether and 120mgrnlumefantrine) is an artemisinin based tablet that provides effective antimalarial treatment againstrnuncomplicated falciparum malaria in many parts of the world, including sub-saharan Africa. Thernpresent study was conducted to monitor the efficacy of this drug in patients 6 months withrnuncomplicated falciparum malaria in Selekleka town, Northwestern Tigray, Ethiopia. A total ofrn98 study participants, microscopically confirmed for P. falciparum mono-infection, werernincluded in the study. Majority of the study participants were adults above 15 years (87.8%). Atrnenrollment, 65 (66%) patients were febrile (T 37.5ºC) and the overall parasite mean densityrnwas 22,679. Six doses of Coartem were given over 3 days, two doses each day, on D0, D1, andrnD2; with a follow up on D3, D7, D14, D21 and D28. The clinical and parasitological conditionsrnof the patients were assessed at each visit. The level of hemoglobin in the study participants wasrndetermined by using hemocue reader. 89 (90.8%) patients completed the 28-day follow-up whilern9 (9.2%) patients were excluded from the study because of loss-to-follow-up and withdrawal ofrnconsent. The ACT treatment rapidly cleared parasitaemia and fever by D2 and completerngametocyte clearance was obtained on D21. Significant (p= 0.05) hemoglobin recovery wasrnobserved among patients with adequate clinical and parasitological response. No severe adversernside-effects, clinical failures or parasitological failures were observed among these patients.rnOverall, the 28-day clinical and parasitological cure rate was 100%. Coartem, therefore, wasrnefficacious for the treatment of uncomplicated falciparum malaria in Selekleka town. However,rnthe reported increasing trend in P. falciparum prevalence since 2007/8 in Selekleka, despite freernavailability of Coartem and ITN coverage, needs further investigation on the efficacy of thernmalaria measures in use.rnKey words: Malaria, P. falciparum, Coartem, Selekleka town, Cure rate, Hemoglobin recovery, Adverse effects

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