Recurrence of Falciparum Malaria under Coartem Treatment in the City of Mâncio Lima, Acre, Brazil: A Retrospective Study

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Andreus Roberto Schlosser
Saulo Augusto Silva Mantovani
Rayanne Alves de Arruda
Felipe Monteiro de Araújo
Rudi Nogueira
Cássio Braga e Braga
Breno Wilson Benevides Andrade
Mardelson Nery de Souza
Thasciany Moraes Pereira
Antonio Camargo Martins
Luiz Fernando Melo Lima
Mônica da Silva-Nunes

Abstract

Background: Malaria remains a health problem in the Amazon and since 2005 the state of Acre has high incidence of malaria. Treatment with Coartem® for cases of falciparum malaria was introduced in Acre in August 2012. In Brazil, there is still no published study on the effectiveness of Coartem in endemic areas.

Methods: This study was conducted in Mâncio Lima, Acre, in the western Brazilian Amazon region. All malaria cases notified in Mâncio Lima between August 01st, 2012 and October 31st, 2013 were revised. The therapeutic response to Coartem in Mâncio Lima, Acre, was evaluated. A recurrence of falciparum malaria was defined as a malaria case occurring in the same patient in a maximum interval of 40 days between the day treatments was started and the day the next diagnosis was made.

Results: All malaria cases (7,171) notified between August 2012 and July 2013 were revised. About 23.72% (n = 1,701) were falciparum malaria. There were six cases of recurrent falciparum malaria that can be classified as treatment failure. All cases had low parasitemia. The minimum and maximum interval between the first and the recurrent malaria episode was 17 days and 33 days. Age range was 9 to 50 years. Two patients were from rural areas, while all others were from riverine areas.

Conclusion: Possible failure to Coartem treatment was identified, however causes are not clear. Further studies are needed.

Keywords:
Amazon, coartem, Plasmodium falciparum, recurrent malaria

Article Details

How to Cite
Schlosser, A. R., Mantovani, S. A. S., Arruda, R. A. de, Araújo, F. M. de, Nogueira, R., Braga, C. B. e, Andrade, B. W. B., Souza, M. N. de, Pereira, T. M., Martins, A. C., Lima, L. F. M., & Silva-Nunes, M. da. (2020). Recurrence of Falciparum Malaria under Coartem Treatment in the City of Mâncio Lima, Acre, Brazil: A Retrospective Study. Asian Journal of Research in Infectious Diseases, 4(2), 1-10. https://doi.org/10.9734/ajrid/2020/v4i230141
Section
Original Research Article

References

Ministério da Saude, Secretaria de Vigilancia em Saude, SIVEP-Malaria.Brasilia (DF): DATASUS: Ministerio da saude.
Available:http://dw.saude.gov.br/gsid/servlet/mstrWeb?evt=2048001&documentID=AC2B0F5041CEEC8C671FA39D5337A697&server=srvbipdf03&project=DMMalaria&uid=convidado&pwd=datasus&hiddensections=header,path,dockTop,dockLeft,footer
[Accessed 20 September 2015]

Ministério da Saúde, Secretaria de Vigilância da Saúde. Malária (todas as formas) - Lâminas positivas por unidade federada, Brasil (1980-2005). Brasília: Secretaria de Vigilância da Saúde, Ministério da Saúde; 2006.
Available:http://dw.saude.gov.br
[Acessed 25 August 2008]

Costa KMM, Almeida WAF, Magalhães IB, et al. Malária em Cruzeiro do Sul (Amazônia Ocidental brasileira): Análise da série histórica de 1998 a 2008. Rev Panam Salud Publica 2010;28(5):353- 60.

Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância Epidemiológica. Guia prático de tratamento da malária no Brasil. Brasília: MS/SVS; 2010.

World Health Organization. Methods for surveillance of antimalarial drug efficacy. Geneva: WHO; 2009.

Aydin-Schmidt B, Mubi M, Morris U, et al. Usefulness of Plasmodium falciparum-specific rapid diagnostic tests for assessment of parasite clearance and detection of recurrent infections after artemisinin-based combination therapy. Malaria Journal. 2013;12:349.

Assefa A, Kassa M, Tadese G, et al. Therapeutic efficacy of Artemether/Lumefantrine (Coartem®) against Plasmodium falciparum in Kersa, SouthWest Ethiopia. Parasites & Vectors 2010;3:1.

Ebstie YA, Zeynudin A, Belachew T, et al. Assessment of therapeutic efficacy and safety of artemether-lumefantrine (Coartem®) in the treatment of uncomplicated Plasmodium falciparum malaria patients in Bahir Dar district, Northwest Ethiopia: An observational cohort study. Malaria Journal. 2015;14:236.

Saha P, Guha SK, Das S, et al. Comparative efficacies of artemisinin combination therapies in Plasmodium falciparum malaria and polymorphism of pf ATPase6, pfcrt, pfdhfr and pfdhps Genes in Tea Gardens of Jalpaiguri District, India. Antimicrobial Agents and Chemotherapy. 2012;56:2511–17.

Instituto Brasileiro de Geografia e Estatística. 2010 PopulationCensus: Synopsis Acre, Mâncio Lima. Rio de Janeiro (RJ): IBGE cidades; 2010.
Available:http://www.cidades.ibge.gov.br/xtras/temas.php?lang=&codmun=120033&idtema=1&search=acre|Mâncio-lima|censo-demografico-2010:-sinopse-
[Accessed: 13 November 2014]

Acre. Governo do Estado do Acre. State Program of Ecological-Economical Assessment of State of Acre. Phase II: Synthesis document. 2nd edition. 1:250.000 scale. Rio Branco; 2010.

Nambozi M, Geertruyden JPV, Hachizovu S, et al. Safety and efficacy of dihydroartemisinin-piperaquine versus artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Zambian children. Malaria Journal. 2011;10:50.

Yavo W, Faye B, Kuete T, et al. Multicentric assessment of the efficacy and tolerability of dihydroartemisinin-piperaquine compared to artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa. Malaria Journal. 2011; 10:198.

Ngasala BE, Mamlberg M, Carlsson AM, et al. Effectiveness of artemetherlumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania: an open label prospective study. Malaria Journal. 2011;10:64.

da Silva-Nunes M, Ferreira MU. Clinical spectrum of uncomplicated malaria in semi-immune Amazonians: beyond the "symptomatic" vs "asymptomatic" dichotomy. Memorias do Instituto Oswaldo Cruz. 2007;102:341-7.

Martins AC, Araújo FM, Braga CB, et al. Clustering symptoms of non-severe malaria in semi-immune Amazonian patients. Peer J. 2015;3:e1325.
DOI: 10.7717/peerj.1325

Ajayi NA, Ukwaja KN. Possible artemisinin-based combination therapy-resistant malaria in Nigeria: a report of three cases. Rev Soc Bras Med Trop. 2013;46(4):525-7.
DOI: 10.1590/0037-8682-0098-2013

Valecha N, Srivastava P, Mohanty SS, et al. Therapeutic efficacy of artemether-lumefantrine in uncomplicated falciparum malaria in India. Malaria Journal. 2009; 8:107.

Ngasala BE, Malmberg M, Carlsson AM, et al. Efficacy and effectiveness of artemether-lumefantrine after initial and repeated treatment in children < 5 years of age with acute uncomplicated Plasmodium falciparum malaria in rural Tanzania: a randomized trial. Clin Infect Dis. 2011;52(7):873-82.
DOI: 10.1093/cid/cir066

Bell DJ, Wootton D, Mukaka M, et al. Measurement of adherence, drug concentrations and the effectiveness of artemether-lumefantrine, chlorproguanil-dapsone or sulphadoxinepyrimethamine in the treatment of uncomplicated malaria in Malawi. Malar J. 2009;8:204.

Piola P, Fogg C, Bajunirwe F, et al. Supervised versus unsupervised intake of six-dose artemether-lumefantrine for treatment of acute, uncomplicated Plasmodium falciparum malaria in Mbarara, Uganda: A randomised trial. Lancet. 2005;365:1467-73.

Checchi F, Piola P, Fogg C, et al. Supervised versus unsupervised antimalarial treatment with six-dose artemether-lumefantrine: pharmacokinetic and dosage related findings from a clinical trial in Uganda. Malar J. 2006;5:59.

White NJ, van Vugt M, Ezzet F. Clinical pharmacokinetics and pharmacodynamics and pharmacodynamics of artemether-lumefantrine. Clin Pharmacokinet. 1999;37:105-25.

Borrmann S, Sallas WM, Machevo S, et al. The effect of food consumption on lumefantrine bioavailability in African children receiving artemether-lumefantrine crushed or dispersible tablets (Coartem) for acute uncomplicated Plasmodium falciparum malaria. Trop Med Int Health. 2010;15:434-41.

Hoffmann EHE, Ribolla PEM, Ferreira MU.Genetic relatedness of Plasmodium falciparum isolates and the origin of allelic diversity at the merozoite surface protein-1 (MSP-1) locus in Brazil and Vietnam. Malar J. 2003;2:24.

Hamainza B, Masaninga F, Moonga H, et al. Therapeutic efficacy of artemetherlumefantrine on treatment of uncomplicated Plasmodium falciparum mono-infection in an area of high malaria transmission in Zambia. Malaria Journal. 2014;13:430.

Phyo AP, Nkhoma S, Stepniewska K, et al. Emergence of artemisinin-resistant malaria on the western border of Thailand: a longitudinal study. Lancet. 2012;379:1960–6.

Dondorp AM, Nosten F, Yi P, et al. Artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med. 2009;361:455–67.

WWARN. The effect of dose on the antimalarial efficacy of artemether–lumefantrine: A systematic review and pooled analysis of individual patient data. Lancet Infect Dis. 2015;15: 692–702.