Artemisin Combined Therapy in malaria patients: Do we need to search for more?

Journal Title: International Journal of Medical Research and Review - Year 2018, Vol 6, Issue 7

Abstract

Introduction: Malaria is a vector borne disease highly prevalent in the topical developing countries. Two main species of plasmodium causing majority of diseases manifestations are P. Vivax and P. falciparum. The approach to antimalarial selection is determined based on the location of the patient. For treatment of uncomplicated P. falciparum malaria, according to WHO guidelines first line therapy mainly includes Artemisin Combined Therapy. Concerns about the emergence of resistance to artemisin derivatives have increased recently. The main aim of the present study is to investigate the effect of using a combination of intravenous artesunate along with oral doxycycline, as a novel ACT for Malarial infections – falciparum vs. vivax. Methodology: Prospective observational study was carried out at V S General Hospital in Ahmedabad, Gujarat, India. A full history of current illness was taken followed by examining the serial peripheral smear reports of the patients till the malarial parasites are not seen on two consecutive occasions. Samples were taken at least 6 hours apart by the capillary method and oral temperature was measured every 6 hours. We excluded other associated viral fevers such as dengue, pediatric age group (<12 years) and Co-Morbid illnesses like hepatic or renal dysfunction. Data analysis was done using SPSS software version 20. Results: Student t test showed that PCT was significantly more in falciparum (mean= 74.53 hours) patients as compared to vivax patients (mean= 51.89 hours). (p<0.001). Also duration of stay was significantly more in patients having falciparum (mean =3.63 days) as compared to patients having vivax (mean = 2.32 days) (p<0.001) Multivariate analysis by linear regression showed that species of the parasite was the most significant independent predictor (B=12.552) of the time to parasite clearance and other significant variable was Grade of parasitemia at 0 hour (B= 12.798). We also found that patients with residual parasitemia was 83.78%, 40.54% and 10.81% in vivax group whereas it was 100%, 88.15% and 46.05% in falciparum respectively at 24, 48 and 72 hours. Conclusion: The study shows that PCT and residual parasitemia is very high in falciparum patients as compared to previous reports of different studies and also as compared to vivax group patients. ACT resistance is a grave concern for falciparum and more studies should be done to understand pathophysiology and its prevalence in India. We strongly suggest that a continues monitoring needs to be implemented in health policy to understand the dynamicity of emerging resistance

Authors and Affiliations

Chinmay Jani, Intern, Neil Palkhiwala, Ami Parikh, Nilay Suthar, Khushali Patel

Keywords

Related Articles

Flow immunophenotyping features of crisis phase of chronic myeloid leukemia in childhood: do we really care?

Objective: Chronic leukemias are rare in childhood & CML is extremely rare in children. Imunophenotypic studies have a limited role in the diagnosis of CML but are increasingly being used in CML blast transformation. Pur...

Fournier's gangrene: a review of 38 cases in a tertiary hospital

Background: Fournier’s gangrene is an infective necrotizing fasciitis of the perineal, genital or perianal regions. It is caused by polymicrobial infection. The infective process leads to thrombosis of subcutaneous blood...

An analysis of adult non-neoplastic nephrectomies at a tertiary care centre in Mumbai

Introduction: Nephrectomies are an integral part of urological practice and a wide range of renal diseases are seen on histopathological examination of non-neoplastic nephrectomy specimens. Objective: The objective of th...

Comparison of thyroid profile in premenopausal and postmenopausal women: A case control study

Introduction : After menopause, diminishedgonadal hormones are found to influence thyroid status. There are a few published literature in this area, to the best of our knowledge. Aim of the study was to compare thyroid p...

Study of relationship between ABO & Rh blood group and type 2 diabetic mellitus

Background & Objective: The findings of Arid et al, in 1953 regarding association between carcinoma of stomach and B blood group and successively in 1954 regarding association between peptic ulcer and O blood group opene...

Download PDF file
  • EP ID EP483164
  • DOI 10.17511/ijmrr.2018.i07.02.
  • Views 173
  • Downloads 0

How To Cite

Chinmay Jani, Intern, Neil Palkhiwala, Ami Parikh, Nilay Suthar, Khushali Patel (2018). Artemisin Combined Therapy in malaria patients: Do we need to search for more?. International Journal of Medical Research and Review, 6(7), 348-354. https://www.europub.co.uk/articles/-A-483164