Therapeutic efficacy of dihydroartemisinin-piperaquine combination for the treatment of uncomplicated malaria in Ghana
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Frontiers in Cellular and Infection Microbiology
Abstract
In 2020, Dihydroartemisinin-Piperaquine (DHAP) was adopted as a second-line
antimalarial for treatment of uncomplicated malaria in Ghana following a
review of the country’s antimalarial medicines policy. Available data obtained
in 2007 had shown PCR-uncorrected therapeutic efficacy of 93.3% using a 28-
day follow-up schedule. In 2020, the standard 42-day follow-up schedule for
DHAP was used to estimate efficacy levels among febrile children aged 6
months to 9 years in three malaria sentinel sites representing the three main
ecological zones of the country- savannah, forest, and coastal. PCR genotyping
distinguished between recrudescence and re-infection using merozoite
surface protein 2 (MSP2)-specific primers for FC27 and 3D7 strains. Per
protocol analyses showed day 28 efficacy of 100% in all three sentinel sites
with day 42 PCR-corrected efficacy ranging between 90.3% (95% CI: 80.1 –
96.4%) in the savannah zone and 100% in the forest and coastal zones, yielding
a national average of 97.0% (95% CI: 93.4 – 98.8). No day 3 parasitemia was
observed in all three sites. Prevalence of measured fever (axillary temperature ≥
37.5°C) declined from 50.0 - 98.8% on day 0 to 7.1-11.5% on day 1 whilst
parasitemia declined from 100% on day 0 to 1.2 - 2.3% on day 1. Mean
haemoglobin levels on days 28 and 42 were significantly higher than pretreatment levels in all three sites. We conclude that DHAP is highly efficacious
in the treatment of uncomplicated malaria in Ghana. This data will serve as
baseline for subsequent DHAP efficacy studies in the country
Description
Research Article
Keywords
efficacy, dihydroartemisinin-piperaquine, uncomplicated malaria, reatment, Ghana
Citation
Abuaku B, Boateng P, Peprah NY, Asamoah A, Duah-Quashie NO, Matrevi SA, Amoako EO, Quashie N, Owusu-Antwi F, Malm KL and Koram KA (2023) Therapeutic efficacy of dihydroartemisinin-piperaquine combination for the treatment of uncomplicated malaria in Ghana. Front. Cell. Infect. Microbiol. 12:1058660. doi: 10.3389/fcimb.2022.1058660