Statin Treatment Modulates Clinical Response to Amodiaquine in Acute Uncomplicated Falciparum Malaria
Ndubuisi N. Nwobodo1* and Paul O. Okonkwo21Department of Pharmacology and Therapeutics, Ebonyi State University, Abakaliki, Nigeria. 2Department of Pharmacology and Therapeutics, University of Nigeria.
Abstract: The efficacy of amodiaquine in the malaria endemic region of sub-Saharan Africa has declined. The use of serum lipid lowering agents as part of management protocol for treatment of malaria infection has been advocated. The aim of present study was to evaluate the clinical response of amodiaquine plus simvastatin combination in relation to amodiaquine alone in the treatment of malaria infection. Subjects with frank malaria (n=60) diagnosed by thick blood film and immunological tests were nominated for the study. Informed written content was obtained and subjects randomized into amodiaquine plus simvastatin (test) and amodiaquine alone (control) groups. The ethical clearance certificate was obtained from the University of Nigeria Teaching Hospital Research Ethics Committee (NHREC/05/01/2008B). The assessment of clinical response was done in line with WHO criteria and patients followed up on days D3, D7, D14 and D28 post-treatment. The GraphPad Prism 4.0 was employed in the analysis of data which was presented as tables and graphs. Statistically significant decrease in the mean early treatment failure given as 2.5±0.11% in the test group relative to 12.5±0.11% reported in the control; similarly the mean late treatment failure given as 7.2±0.34% in the test group was decreased relative to 20.3±0.17% in the control. A statistically significant increase was reported in adequate clinical and parasitological response given as 90.3±0.55% in the test group relative to 67.2±0.45% in the control. There was statistically significant reduction in the mean parasite clearance time in the test group given as 2.8±0.19 days relative to 6.3±0.27days in the control. Similarly, the fever clearance time given as 24.3±1.13 hours was significantly reduced relative to 66 ±2.1 hours rported in the control. A statistically significant increase in the clinical clearance rate given as 96.3±0.5% was recorded in the test group as compared to the 71.6±2.1% recorded in the control. A statistically significant decrease in the recrudescence rate given as 6.4±0.0.1% in the test group relative to 13.6±0.16% in the control was also reported. Evidently, the enhanced clinical response obtained in the test subjects relative to control in present study, can only be attributed to the modulating influence of the HMG-CoA reductase inhibitor, simvastatin.
Keywords: Amodiaquine; Clinical response; Falciparum malaria; Statin; Treatment failure Back to TOC