Monitoring the Efficacy of Artemether-Lumefantrine in the Treatment of Uncomplicated Plasmodium Falciparum Malaria by Kelch 13 Gene Mutations in Bangui, Central African Republic

• Published in: Médecine tropicale et santé internationale Vol. 1; no. 1
• Main Authors: Nambei, W S, Biago, U, Balizou, O, Pounguinza, S, Moyen, M, Ndoua, C, Gody, J C
• Format: Journal Article
• Language: French
• Published: France 31.03.2021
• Subjects: Antimalarials - therapeutic use; Artemether - therapeutic use; Artemether, Lumefantrine Drug Combination - therapeutic use; Artemisinins - therapeutic use; Central African Republic; Child; Cross-Sectional Studies; Drug Combinations; Ethanolamines - therapeutic use; Fluorenes - therapeutic use; Humans; Malaria - drug therapy; Malaria, Falciparum - drug therapy; Mutation; Treatment Outcome; Central African Republic; Plasmodium falciparum; Bangui; Uncomplicated malaria; Central African Republic; Children; Hospital; K13; Sub-Saharan Africa; Artemether-lumefantrine
• DOI: 10.48327/mtsibulletin.n1.2021.82

Drug resistance remains a major challenge for the management of malaria. This study investigated the efficacy of antimalarial combination artemether-lumefantrine (AL) in the treatment of uncomplicated malaria in Bangui, Central African Republic. An evaluative cross-sectional study was conducted between the 15th February and the 7th March 2017 in the Complexe Pédiatrique in Bangui among children aged 6 months to 15 years. Clinical outcome was classified according to WHO criteria as adequate clinical and parasitological response (ACPR), late parasitologic failure (LPF), late clinical failure (LCF), and early treatment failure (ETF). The occurrence of mutations in the K 13 gene was studied by PCR-RFLP. A total of 55 patients were included. After PCR correction, ACPR at D28 was 97.8% and LCF was 2.2%. Treatment failures were due to new infections. No mutations in the K-13 gene associated with artemisinin resistance were identified. All participants had wild type alleles. The decrease of anemia and fever was substantial. This study showed that AL remained efficacious and well-tolerated. However, all participants in Central African Republic had wild type alleles unlike contrary in Rwanda where a R561H mutation has been identified. A regular monitoring of efficacy and study of molecular markers of drug resistance to artemisinin is essential.