quinine – afrjcem.org

^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. Continue reading “Malaria treatment failure after Artemisinin-based combination therapy: A case series of children managed at a private tertiary hospital in southwest Nigeria”

*1Adeyemi, O. I., 1Ige, O. O., 1Akanmu, M. A., and 2Ukponmwan, O. E.

1Department of Pharmacology, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria

2Department of Medical Pharmacology and Therapeutics, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria

*Correspondence to: wadeyemi01@yahoo.com & isaacon@oauife.edu.ng

Abstract:

Background: Malaria is a mosquito-borne infectious disease caused by Plasmodium spp, which is widespread in tropical and subtropical regions of the world. The objective of this study is to evaluate in vivo antimalarial activity of propranolol against experimental Plasmodium berghei ANKA (PbA) infection in a mouse model.

Methods: A total of 36 mice weighing between 15 to 18g were randomly divided into six groups of six mice each. Mice in the first group (SAL) were non-infected with P. berghei but received normal saline (control), second group (PbA) were mice infected without treatment (control), third group (PRL) were non-infected mice treated with propranolol at the dose of 7.5 mg/kg/bid, fourth group (PbA+PRL) were mice infected and treated with same dose of propranolol, fifth group (QUN) were non-infected mice treated with quinine at a dose of 20 mg/kg stat, then 10 mg/kg bid, and sixth group (PbA+QUN) were infected mice treated with quinine. Parasitaemia, physiological conditions (cognitive function, temperature) and lethality of infected mice were monitored over 7-day period to assess the antimalarial activity of propranolol and quinine. The Y-maze paradigm was used to assess cognitive impairment induced by PbA infection. The effects of propranolol on malaria indices and cognitive impairment were compared with that of quinine and the control using T-test statistical method.

Results: Mortality of mice at day 7 in the infected group without treatment (PbA) was 100% (6/6) while mortality was 50% (3/6) in infected group treated with propranolol (PbA+PRL) and 33.3% (2/6) in infected group treated with quinine (PbA+QUN) (OR=2.000, p=1.000). No mortality was recorded in any of the three groups of uninfected mice. Propranolol reduced parasitaemia to a trough level of 1.40±0.07 three days after treatment, comparable to trough level of 1.39±0.0633 by quinine but did not reverse PbA-induced hypothermia, which quinine did.

Conclusion: Propranolol demonstrated in vivo antimalarial activity against experimental PbA infection in mice comparable to that of quinine.

Keywords: malaria, propranolol, quinine, Plasmodium, cerebral malaria
Continue reading “In vivo anti-malarial activity of propranolol against experimental Plasmodium berghei ANKA infection in mice”