Anti-plasmodial activity of artemether-lumefantrine-tinidazole on plasmodium falciparum infected humans

Authors

  • Akindele E. Oni Department of Pharmacology, Faculty of Basic Clinical Sciences, University of Port Harcourt, Rivers State, Nigeria
  • Udeme O. Georgewill Department of Pharmacology, Faculty of Basic Clinical Sciences, University of Port Harcourt, Rivers State, Nigeria

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20243026

Keywords:

Anti-plasmodial activity, Artemether-lumefantrine, Hematological parameters, Malaria treatment, Plasmodium falciparum, Tinidazole

Abstract

Background: The emergence of multi-drug resistant strains of Plasmodium falciparum has intensified the search for effective compounds. This study aimed to evaluates the combined effects of tinidazole and artemether/lumefantrine on human participants infected with P. falciparum.

Methods: The study involved 25 non-infected adults as controls and 75 infected adults, divided into three groups of 25. The groups were treated orally with 1g of Tinidazole (T) twice daily for 3 days, an 8-hourly initial dose followed by 12-hourly 80mg/480mg doses of Artemether/Lumefantrine (AL) for 3 days, and a combination of 1g tinidazole and artemether/lumefantrine (80mg/480mg) for 3 days. Venous blood samples were taken on days 0, 4, and 14 to evaluate renal function, parasitemia, hematological parameters, lipid profiles, and antioxidant measures (catalase, SOD, glutathione peroxidase, and malondialdehyde).

Results: The percentage recovery with AL, T, and the combination of T and AL was 88%, 92%, and 100%, respectively. Malaria patients exhibited significantly lower levels of red blood cells, hemoglobin, packed cell volume, low-density lipoprotein, high-density lipoprotein, total cholesterol, catalase, superoxide dismutase, and glutathione peroxidase, and higher levels of white blood cells, triglycerides, and malondialdehyde compared to the control group. Post-treatment, there was a modest reversal on day 4 and a significant return to normal ranges by day 14. Malaria infection did not affect urea or creatinine levels.

Conclusions: Tinidazole shows potential as a treatment for P. falciparum, with enhanced efficacy when combined with artemether/lumefantrine.

References

White NJ. Can new treatment developments combat resistance in malaria? Expert Opin Pharmacother 2016;17(10):1303-7.

World Health Organization. World Malaria Report, 2021. Available at: https://iris.who.int/bitstream/handle/10665/350147/9789240040496-eng.pdf?sequence=1. Accessed 01 July 2024.

Oladipo HJ, Tajudeen YA, Oladunjoye IO, Yusuff SI, Yusuf RO, Oluwaseyi EM, et al. Increasing challenges of malaria control in sub-Saharan Africa: priorities for public health research and policymakers. Ann Med Surg. 2022;81:104366.

Badmos AO, Alaran AJ, Adebisi YA, Bouaddi O, Onibon Z, Dada A, et al. What sub-Saharan African countries can learn from malaria elimination in China. Trop Med Health. 2021;49:86.

Ariey F, Witkowski B, Amaratunga C, Beghain J, Langlois AC, Khim N, et al. A molecular marker of artemisinin-resistance plasmodium falciparum malaria. Nature. 2014;505(7481):50-5.

Talapko J, Škrlec I, Alebić T, Jukić M, Včev A. Malaria: the past and the present. Microorganisms. 2019;7(6):179.

World Health Organization. World malaria report, 2022. Available at: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022. Accessed 01 July 2024.

Ndoreraho A, Shakir M, Ameh C, Umeokonkwo C, Aruna O, Ndereye J, et al. Trends in malaria cases and deaths: assessing national prevention and control progress in Burundi. East Afr Health Res J. 2020;4(2):182-8.

Touré M, Keita M, Kané F, Sanogo D, Kanté S, Konaté D, et al. Trends in malaria epidemiological factors following the implementation of current control strategies in Dangassa, Mali. Malar J. 2022;21(1):65.

Nyasa RB, Fotabe EL, Ndip RN. Trends in malaria prevalence and risk factors associated with the disease in Nkongho-mbeng; a typical rural setting in the equatorial rainforest of the South West Region of Cameroon. PLoS ONE. 2021;16(5):e0251380.

Singh A, Sharma J, Paichha M, Chakrabarti R. Achyranthes aspera (Prickly chaff flower) leaves-and seeds-supplemented diets regulate growth, innate immunity, and oxidative stress in Aeromonas hydrophila-challenged Labeo rohita. J Appl Aqua. 2020;32(3):250-67.

Khataniar A, Pathak U, Rajkhowa S, Jha AN. A comprehensive review of drug repurposing strategies against known drug targets of COVID-19. COVID 2022;2(2):148-67.

Enechi OC, Amah CC, Okagu IU, Ononiwu CP, Azidiegwu VC, Ugwuoke EO, et al. Methanol extracts of Fagara zanthoxyloides leaves possess antimalarial effects and normalizes haematological and biochemical status of Plasmodium berghei-passaged mice. Pharmac Biol. 2019; 57(1):577-85.

Ryley JF, Peters W. The antimalarial activity of some quinolone esters. Annal Trop Med Parasit. 1970;64(2):209-22.

Marklund S, Marklund G. Involvement of the superoxide anion radical in the autoxidation of pyrogallol and a convenient assay for superoxide dismutase. Euro J Biochem. 1974;47(3):469-74.

Gboeloh LB, Nworgu CO. Repurpose of mefloquine-cotrimoxazole combination as anti-plasmodial agents in mice infected with Pasmodium Berghei. A J Pure Appl Sci. 2023; 4(1):24-35.

Dondorp AM, Nosten F, Yi P, Das D, Phyno AP, Tarning J, et al. Artemisinin resistamce in plasmodium falciparum malaria. N Engl J Med. 2009;361(5):455-67.

Nosten F, Brasseur P, Baird JK. Combination therapy for malaria: a summary of the evidence. Clinic Infect Dis. 2000;30(2):317-24.

Oduola AMJ, Adetunji AA, Taiwo O. Efficacy of Artemether-Lumefantrine and its implications on malaria treatment in Nigeria. A J Pharm Pharmacol. 2018;12(9):141-7.

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Published

2024-10-23

How to Cite

Oni, A. E., & Georgewill, U. O. (2024). Anti-plasmodial activity of artemether-lumefantrine-tinidazole on plasmodium falciparum infected humans. International Journal of Basic & Clinical Pharmacology, 13(6), 805–812. https://doi.org/10.18203/2319-2003.ijbcp20243026

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Original Research Articles