1,2*†Fatunla, O. A. T., 3,4†Irek, E. O., 1,2Oyebanji, A. H., 2Adisa, S. O., [1]Jesulana, T. E., and 2Ajibola, T. O.
1Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
2Department of Paediatrics, Afe Babalola Multi-System Hospital, Ado-Ekiti, Nigeria
3Department of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
4Department of Medical Microbiology and Parasitology, Afe Babalola Multi-System Hospital, Ado-Ekiti, Nigeria
5Department of Internal Medicine, Afe Babalola Multi-System Hospital, Ado-Ekiti, Nigeria
*Correspondence to: odunayofatunla@abuad.edu.ng; +2348034397539; ORCiD: //orcid.org/0000–0002–2839–1491
†Contributed equally to the study
Abstract:
Malaria treatment failure is the inability to clear parasitaemia after antimalarial drug administration. There are reports of treatment failure with artemisinin-based combination therapy (ACT) in Nigeria but few reported among children. We report three paediatric cases of treatment failure with ACT admitted at a private tertiary hospital in Nigeria in early 2022. All three were ‘under-fives’ admitted for open-heart surgery, major flame burns, and cerebral malaria respectively. They had symptomatic Plasmodium falciparum infection but one had mixed P. falciparum and Plasmodium vivax infections. Cases 1 and 2 were initially given oral artemether-lumefantrine while case 3 received intravenous artesunate. Despite appropriate antimalarial drug compliance, all the 3 still had fever with heavy parasitaemia. They subsequently received intravenous quinine, with improvement within the first 24 hours of therapy, and no longer had fever at the fourth week of follow-up. Although ACT resistance was not established, poor drug quality may have contributed to treatment failure. There is a need for pharmacovigilance of anti-malarial in Nigeria.
Keywords: Artemisinin, Quinine, Malaria, Plasmodium vivax, Treatment failure, Nigeria
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