Prevalence of Clinical Artesunate Resistance among Cases of Complicated Malaria in Southern Odisha, IndiaCorrespondence Address :
Dr. Sanghamitra Padhi,
Department of Microbiology, M.K.C.G.Medical College, Berhampur, Odisha, India.
Introduction: Drug resistant malaria represents the most challenging health problem worldwide. The major threat to malaria control is the increasing incidence of complicated and drug-resistant cases.
Aim: To determine the prevalence of clinical artesunate resistance among complicated malaria cases by invivo method.
Materials and Methods: The study included 241 patients with complicated malaria, which showed trophozoites of malarial parasite Plasmodium in the blood smear. They were administered with artesunate monotherapy. They were then followed-up for clinical response to therapy and quantification of parasitaemia levels on day 1, day 2, day 3, day 7, day 14 and day 28. Clinical examination included core body temperature recording, assessment of associated complications like vomiting, altered sensorium, anaemia, bleeding tendencies, and investigation of renal parameters, liver function test and hypoglycaemia.
Results: Out of 241 complicated malaria cases showing malarial parasite in peripheral blood smear, 204 cases were of Plasmodium falciparum, 32 cases were of Plasmodium vivax and five were cases of mixed Plasmodium falciparum and Plasmodium vivax infection. Among the 241 malaria positive cases, the most commonly associated complication was severe anaemia in 87 (36.1%) cases. All the 32 cases of Plasmodium vivax malaria and the five cases of mixed infection responded and recovered after administration of artesunate monotherapy. But among the 204 cases of Plasmodium falciparum, clinical artesunate resistance was detected in 6 (2.94%) cases and the rest 198 (97.06%) cases were sensitive to artesunate monotherapy.
Conclusion: Clinical artesunate resistance was noticed in 2.94% cases of Plasmodium falciparum malaria. Hence, continuous monitoring of antimalarial therapy is required, especially in complicated cases of Plasmodium falciparum malaria, to prevent the emergence of artesunate resistance.
Antimalarial resistance, Drug resistant malaria, Injectable artesunate monotherapy
Date of Submission: Oct 03, 2017
Date of Peer Review: Dec 06, 2017
Date of Acceptance: Jun 26, 2018
Date of Publishing: Sep 01, 2020
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 04, 2017
• Manual Googling: Jun 08, 2020
• iThenticate Software: Aug 25, 2020 (13%)
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- Indian Science Abstracts (ISA)
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- Popline (reproductive health literature)