Treatment of chloroquine-resistant P. Falciparum malaria with artesunate-doxycycline combination therapy in Jordanian soldiers-sierra leone

Abstract EN

The aim of this study is to evaluate the efficacy of combined Artesunate-Doxycycline therapy in patients with Chloroquine -resistant V.

Falciparum malaria.

A prospective study of 52 Jordanian soldiers among United Nation troops of peace keeping in Sierra Leone, who were infected with chloroquine resistant P.Falciparum malaria over a period of 6 months (June-December 2000) were subjected to treatment with 5 days artesunate and 14 days doxycycline combination therapy.

Diagnosis andfollow up was done with thin and thick smears stained with Leishman stain, as well as withQBC method using acredine orange stain under UV light.

The follow up was done over a period interval of 4 weeks.

Fever and boneaches were the major presenting symptoms, the majority ofpatients felt well within 24 hours with dramatic improvement of their symptoms within 2 days, and by the 7,b day all patients were free of any residual sy ?nptom.

Pallor, soft splenomegaly and tinje of jaundice were seen in a considerable number ofpatients, splenomegaly and hepatomegaly have persisted for the next 2-4 weeks of initiating treatment.

The earliest form ofparasitemia, which has disappeared from peripheral blood, is the ring stage, followed by leukocyte pigments and ultimately by the gametocyte (sexual) form.

Artesunate, a Chinese herbal drug, has -an excellent antimalarial effect especially against the asexualforms of the chloroquine- resistant P.

Falciparum malaria.

It brings a rapid and dramatic subjective improvement on a 5-day therapeutic course, and despite the fact that it has neurotoxicity in experimental animals, it is safe when used in human beings.

Combined with 14 days of Doxycycline therapy, which has antimalarial effect against both sexual and asexual forms of the chloroquine-resistant P.

Falciparum malaria, can enhance the antimalarial effect of the former and clears the gametocyte form efficiently.