Nutritional Advice El Mondo
Objectives:
Malaria is a major public health problem in endemic countries including Sudan, where about 75% of populations are at risk. Due to widespread of chloroquine-resistant strains of Plasmodium falciparum, artemisinin-based combination therapy (ACT) is currently treatment of choice for malaria in the vast majority of malaria-endemic countries. Although there are several studies that were conducted to assess the efficacy of malaria treatment agents yielding different success rates in Sudan, there has been no systematic review and/or meta-analysis conducted to obtain strong evidence about the outcome of malaria treatment. Therefore, this review article has been conducted.
The aim of this review article is to obtain an overall stronger evidence of the outcomes of artemisinin-based combination therapy in the treatment of uncomplicated falciparum malaria from the existing literature in Sudan.
Study design:
This review article included 20 studies (artemisinin-based combination therapy in the treatment of uncomplicated falciparum malaria) with a total number of 4,070 participants that ranged from 30 patients to 1,463 patients.
Malaria treatment outcome was assessed using World Health Organization guidelines.
Adequate clinical and parasitological response was used to assess treatment success at the 28th day.
Results and conclusions:
The investigators found that treatment success of all combined studies was 98% [95% CI = 97.2-98.8%, p 0.001].
The investigators found that treatment success was higher in malaria patients treated with artemether + lumefantrine (AL) than patients treated with artesunate + sulfadoxine-pyrimethamine (AS + SP) [98.9%, 95% CI = 98.4-99.4% vs 97.1%. 95% CI = 95.5-98.6%, p 0.001].
The investigators found 11 studies reported adverse drug reactions (ADRs) to artemisinin-based combination therapy [184 participants out of 3957 (4.65%)]. The ADRs were mild and resolved spontaneously. There was no severe ADRs or deaths.
The investigators concluded that the overall success of treatment of uncomplicated falciparum malaria in Sudan is high (98%). Artemether + lumefantrine regimen shows higher efficacy compared to artesunate + sulfadoxine-pyrimethamine for treatment of uncomplicated falciparum malaria. The overall regimens are associated with mild low rates adverse drug reactions. Although the results of this review showed that the current malaria treatment agents in Sudan are effective and safe, greater efforts need be taken to develop new and more potent anti-malarial agents to prevent resistance which has been reported in other areas of the world.
Original title:
Efficacy and safety of artemisinin-based combination therapy for uncomplicated Plasmodium falciparum malaria in Sudan: a systematic review and meta-analysis by Adam I, Ibrahim Y and Gasim GI.
Link:
https://malariajournal.biomedcentral.com/articles/10.1186/s12936-018-2265-x
Additional information of El Mondo:
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