Efficacy of artesunate-amodiaquine combination therapy for uncomplicated malaria in patients in south-eastern Nigeria

Context/Objective: Artemisinin combination therapy (ACT) is currently the recommended first line treatment for uncomplicated malaria. However, with a plethora of ACTs currently available in Nigeria, it is pertinent to establish the efficacy of these drugs in clinical settings. This study aimed at evaluating the efficacy of the artesunate amodiaquine combination in a rural community of south-eastern Nigeria. Method: This was a randomized prospective study, which employed the assessment of day 14 clinical and parasitemia responses. It was conducted in a hospital in Ibagwa, a rural community in the outskirts of Enugu State, Nigeria. Patients who consented to enrolment had detectable parasitemia, no history of prior antimalarial drug use and a history of fever. Each patient received appropriate doses of the artesunate-amodiaquine combination and on days 4 and 14, parasitemia levels were determined micro scopically and clinical responses assessed physically. Results: Results showed a preponderance of children (71.4%) and females (62.2%) in this study. Fever, weakness, headache and malaise were the most reported complaints on day 1. By day 14, there was complete resolution of fever, emesis, and pains in all the patients with the least effect seen on weakness, pallor and hematomegaly. Cure rate in this population on days 4 and 14 were 67% and 99% respectively. There were no significant changes in hemoglobin, electrolyte sedimentation rate and leukocyte count. Severe weakness was the only reported side effect. Conclusion: This study showed a high efficacy of this combination in treatment of uncomplicated malaria in this population with few side effects.