A comparative study of Artesunate-Lumefantrine vs. Chloroquine-Pyrimethamine-Sulfadoxine efficacy for the treatment of uncomplicated Plasmodium falciparum in tribal population in Bastar (Chhattisgarh).

Abstract

Objective: It was a comparative study to asses the efficacy of Artesunate-lumefantrine and Chloroquine-PyrimethamineSulfadoxine in the treatment of uncomplicated Plasmodium falciparum in tribal population in Bastar (Chhattisgarh). Patient and method: The study was carried out in Department of Medicine, Government Medical College, Jagdalpur. 91 patients who full filed the inclusion criteria were enrolled after taking written consent to participate in study. All the baseline parameters follow up progress and adverse drug reactions were recorded on the personal record of every individual patient. Results were analyzed with paired t test and chi square test. Results: Among the 91 patients, 55 were treated with Artemether-lumefantrine (AL) and 36 with Chloroquine+ Pyrimethamine-Sulfadoxine (CPS) combination. We noted that fever clearance time and parasite clearance time were longer in CPS treated group as compared to AL treated groups (1.1 days vs 1 day, P = 0.03; and 1.7 days vs. 2.1 days, P < 0.003, respectively) and the parasitaemia clearance time in Artemether +lumefantrine group was statistically very significant. Patient’s cured (%) were 100% and 90% in AL and CPS treated groups respectively. The most common adverse effects noted in AL and CPS treated groups were abdominal pain (8.2%) and nausea/vomiting (14.7%) respectively. Hematological, biochemical and other parameters remained normal before and after treatment in all subjects. Conclusion: Both Combinations, AL and CPS were well tolerated for the treatment of uncomplicated falciparum malaria in tribal population in Bastar (Chhattisgarh). However, AL showed significantly higher efficacy than CPS combination, this may be due to the high prevalence of resistance against Chloroquine combination and better patient compliance in AL treatment.