Impact of Intervention Practices on Recurrence of Parasitemia among Artemether-Lumefantrine (Al) Treated Patients in Bushenyi District, Uganda

Authors

  • Josephat Nyabayo Maniga Department of Medical Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda. Department of Medical Microbiology, Immunology and Parasitology, Kampala International University In Tanzania.
  • Rasheed Omotayo Adeyemo Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Odda John School of Pharmacy, Kampala International University Western Campus, Bushenyi, Uganda. Department of Pharmacology and Therapeutics, Makerere University, Kampala, Uganda. Department of Pharmacology and Toxicology, School of Medicine, King Caesor University, Kampala, Uganda.
  • Martin Odoki Department of Medical Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda. Department of Medical Microbiology and Immunology, School of Medicine, King Ceasor University, Kampala, Uganda. Department of Applied Sciences, School of Sciences, Nkumba University, Entebbe, Uganda.
  • Vidya Sankarapandian Department of Medical Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda.
  • Moindi Jeridah Kemunto Department of Medical Microbiology, Immunology and Parasitology, Kampala International University In Tanzania.
  • Jacqueline Njeri Muchiri School of Pharmacy, Kampala International University Western Campus, Bushenyi, Uganda.
  • Ochweri Albert School of Pharmacy, Kampala International University Western Campus, Bushenyi, Uganda.
  • Sarah Kemuma Onkoba Department of Medical Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda. Department of Medical Microbiology, Immunology and Parasitology, Kampala International University In Tanzania.
  • Annette Uwineza Department of Medical Biochemistry, Molecular Biology, and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Alexis Rugamba Department of Medical Biochemistry, Molecular Biology, and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Evelyne Kantarama Department of Medical Biochemistry, Molecular Biology, and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Tolessa Muleta Daba Department of Medical Biochemistry, Molecular Biology, and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Jean Paul Sinumvayo Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Taofeek Tope Adegboyega Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Muritala Issa Bale Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Saheed Adekunle Akinola Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
  • Ismail Abiola Adebayo Department of Medical Biochemistry, Molecular Biology, and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.

Keywords:

Recurrence, parasitemia, Artemether-Lumefantrine

Abstract

Malaria remains a major vector borne disease causing both mortalities and morbidities in the world. Uganda, a moderate intensity malaria transmission country has currently scaled out major campaigns to reduce and eliminate the disease using different interventions together with Artemether-Lumefantrine (AL) drug as a drug of choice for treatment. Different sensitivity profiles have been reported in different parts of the world. This might be influenced by different factors. Therefore, this study was aimed at assessing the impact of previous and current interventions among Artemether-Lumefantrine (AL) treated patients of Bushenyi district, Uganda, for sensitivity profiles. This was a descriptive cross-sectional study carried out among a cohort of 184 study participants for a period of one year (August 2017 to August 2018) in four selected health centers in Bushenyi district, Uganda. The investigative methods used included a researcher administered questionnaire, direct observations, laboratory, and clinical evaluation of participants. Data analysis was done by using statistical package for social sciences (SPSS version 10 windows) for descriptive statistics. Statistically significant factors for recurrence of parasitemia after treatment at p ≤ 0.05 were; practicing indoor residual spraying (IRS) at home (ð‘ƒÂ = 0.001; CI), source of previous drug prescription (ð‘ƒÂ = 0.018; CI), previous finishing of drug dosage (ð‘ƒÂ = 0.006; CI), frequency of previous malaria infection (ð‘ƒÂ = 0.028; CI), Frequency of previous antimalarial usage (ð‘ƒÂ = 0.042; CI) and sleeping under insecticide treated nets (ITNs) (ð‘ƒÂ = 0.039; CI), respectively. Indoor residual spraying and insecticide treated nets were found to be the major intervention practice of malaria reduction after treatment with Artemether- Lumefantrine. 

References

World Health Organization. Global technical strategy for malaria 2016-2030. World Health Organization; 2015.

Global WH. World malaria report 2019. WHO Regional Office for Africa. 2019.

Uganda National Malaria Control Division (NMCD), Uganda Bureau of Statistics (UBOS), and ICF. Uganda malaria indicator survey. 2018-19.

Mandara CI, Kavishe RA, Gesase S, Mghamba J, Ngadaya E, Mmbuji P, Mkude S, Mandike R, Njau R, Mohamed A, Lemnge MM. High efficacy of artemether–lumefantrine and dihydroartemisinin–piperaquine for the treatment of uncomplicated falciparum malaria in Muheza and Kigoma Districts, Tanzania. Malaria journal. 2018;17(1):1-1.

Nanyunja M, Nabyonga Orem J, Kato F, Kaggwa M, Katureebe C, Saweka J. Malaria treatment policy change and implementation: the case of Uganda. Malaria research and treatment. 2011;2011.

Uganda Ministry of Health. Uganda clinical guidelines. 2016.

Uganda Bureau of Statistics. GOVERNMENT OF UGANDA Uganda Demographic and Health Survey 2016. Udhs 2016. 2016:625.

Apinjoh TO, Anchang-Kimbi JK, Ajonina MU, Njonguo ET, Njua-Yafi C, Ngwai AN, Mugri RN, Achidi EA. In vivo efficacy of artesunate/sulphadoxine-pyrimethamine versus artesunate/amodiaquine in the treatment of uncomplicated P. falciparium malaria in children around the slope of mount Cameroon: a randomized controlled trial. Biomedicines. 2016;4(1):5.

Kassam R, Collins JB, Liow E, Rasool N. Narrative review of current context of malaria and management strategies in Uganda (Part I). Acta tropica. 2015;152:252-68.

World Health Organization. Methods and techniques for clinical trials on antimalarial drug efficacy: genotyping to identify parasite populations: informal consultation organized by the Medicines for Malaria Venture and cosponsored by the World Health Organization, 29-31 May 2007, Amsterdam, The Netherlands. World Health Organization; 2008.

Muhindo MK, Kakuru A, Natureeba P, Awori P, Olwoch P, Ategeka J, Nayebare P, Clark TD, Muehlenbachs A, Roh M, Mpeka B. Reductions in malaria in pregnancy and adverse birth outcomes following indoor residual spraying of insecticide in Uganda. Malaria journal. 2016;15:1-9.

Ssempiira J, Nambuusi B, Kissa J, Agaba B, Makumbi F, Kasasa S, Vounatsou P. The contribution of malaria control interventions on spatio-temporal changes of parasitaemia risk in Uganda during 2009–2014. Parasites & vectors. 2017;10(1):1-3.

Kamya MR, Arinaitwe E, Wanzira H, Katureebe A, Barusya C, Kigozi SP, Kilama M, Tatem AJ, Rosenthal PJ, Drakeley C, Lindsay SW. Malaria transmission, infection, and disease at three sites with varied transmission intensity in Uganda: implications for malaria control. The American journal of tropical medicine and hygiene. 2015;92(5):903.

Bosman A, Mendis KN. A major transition in malaria treatment: the adoption and deployment of artemisinin-based combination therapies. Defining and Defeating the Intolerable Burden of Malaria III: Progress and Perspectives: Supplement to Volume 77 (6) of American Journal of Tropical Medicine and Hygiene. 2007.

Lin JT, Juliano JJ, Wongsrichanalai C. Drug-resistant malaria: the era of ACT. Current infectious disease reports. 2010;12:165-73.

Sangowawa AO, Amodu OK, Olaniyan SA, Amodu FA, Olumese PE, Omotade OO. Factors associated with a poor treatment outcome among children treated for malaria in Ibadan, southwest Nigeria. Epidemiology Research International. 2014;2014.

Balikagala B, Mita T, Ikeda M, Sakurai M, Yatsushiro S, Takahashi N, Tachibana SI, Auma M, Ntege EH, Ito D, Takashima E. Absence of in vivo selection for K13 mutations after artemether–lumefantrine treatment in Uganda. Malaria Journal. 2017;16:1-1.

Muhindo MK, Kakuru A, Jagannathan P, Talisuna A, Osilo E, Orukan F, Arinaitwe E, Tappero JW, Kaharuza F, Kamya MR, Dorsey G. Early parasite clearance following artemisinin-based combination therapy among Ugandan children with uncomplicated Plasmodium falciparum malaria. Malaria journal. 2014;13:1-8.

Bukirwa H, Yeka A, Kamya MR, Talisuna A, Banek K, Bakyaita N, Rwakimari JB, Rosenthal PJ, Wabwire-Mangen F, Dorsey G, Staedke SG. Artemisinin combination therapies for treatment of uncomplicated malaria in Uganda. PLoS clinical trials. 2006;1(1):e7.

Yeka A, Kigozi R, Conrad MD, Lugemwa M, Okui P, Katureebe C, Belay K, Kapella BK, Chang MA, Kamya MR, Staedke SG. Artesunate/amodiaquine versus artemether/lumefantrine for the treatment of uncomplicated malaria in Uganda: a randomized trial. The Journal of infectious diseases. 2016;213(7):1134-42.

Ocan M, Bwanga F, Bbosa GS, Bagenda D, Waako P, Ogwal-Okeng J, Obua C. Patterns and predictors of self-medication in northern Uganda. PloS one. 2014;9(3):e92323.

Kamya MR, Yeka A, Bukirwa H, Lugemwa M, Rwakimari JB, Staedke SG, Talisuna AO, Greenhouse B, Nosten F, Rosenthal PJ, Wabwire-Mangen F. Artemether-lumefantrine versus dihydroartemisinin-piperaquine for treatment of malaria: a randomized trial. PLoS clinical trials. 2007;2(5):e20.

Omole MK, Onademuren OT. A survey of antimalarial drug use practices among urban dwellers in Abeokuta, Nigeria. African Journal of Biomedical Research. 2010;13(1):1-7.

Kigozi R, Baxi SM, Gasasira A, Sserwanga A, Kakeeto S, Nasr S, Rubahika D, Dissanayake G, Kamya MR, Filler S, Dorsey G. Indoor residual spraying of insecticide and malaria morbidity in a high transmission intensity area of Uganda. Kigozi R, Baxi SM, Gasasira A, Sserwanga A, Kakeeto S, et al. Indoor Residual Spraying of Insecticide and Malaria Morbidity in a High Transmission Intensity Area of Uganda. PLOS ONE. 2012;7(8):e42857

Degefa T, Yewhalaw D, Zhou G, Lee MC, Atieli H, Githeko AK, Yan G. Indoor and outdoor malaria vector surveillance in western Kenya: implications for better understanding of residual transmission. Malaria journal. 2017;16:1-3.

Ochomo E, Bayoh NM, Kamau L, Atieli F, Vulule J, Ouma C, Ombok M, Njagi K, Soti D, Mathenge E, Muthami L. Pyrethroid susceptibility of malaria vectors in four Districts of western Kenya. Parasites & vectors. 2014;7:1-9.

Zhou G, Munga S, Minakawa N, Githeko AK, Yan G. Spatial relationship between adult malaria vector abundance and environmental factors in western Kenya highlands. The American journal of tropical medicine and hygiene. 2007;77(1):29-35.

UBOS I. Uganda demographic and health survey 2016. Kampala: UBOS and ICF. 2018.

Wanzira H, Yeka A, Kigozi R, Rubahika D, Nasr S, Sserwanga A, Kamya M, Filler S, Dorsey G, Steinhardt L. Long-lasting insecticide-treated bed net ownership and use among children under five years of age following a targeted distribution in central Uganda. Malaria journal. 2014;13:1-8.

Muhumuza E, Namuhani N, Balugaba BE, Namata J, Kiracho EE. Factors associated with use of malaria control interventions by pregnant women in Buwunga subcounty, Bugiri District. Malar J. 2016;6(3):15-342.

Taremwa IM, Ashaba S, Adrama HO, Ayebazibwe C, Omoding D, Kemeza I, Yatuha J, Turuho T, MacDonald NE, Hilliard R. Knowledge, attitude and behaviour towards the use of insecticide treated mosquito nets among pregnant women and children in rural Southwestern Uganda. BMC Public Health. 2017;17:1-8.

Mutagonda RF, Kamuhabwa AA, Minzi OM, Massawe SN, Maganda BA, Aklillu E. Malaria prevalence, severity and treatment outcome in relation to day 7 lumefantrine plasma concentration in pregnant women. Malaria journal. 2016;15:1-0.

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Published

2023-06-28

Issue

Vol. 8 No. 1 (2023): JUNE 2023

Section

Journal of Biomedical and Clinical Sciences

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