Evaluation of Factors contributing to Artemether-Lumefantrine Treatment Failure in Pediatric Falciparum Malaria: Study at Wad-Medani Pediatric Teaching Hospital, Sudan
DOI:
https://doi.org/10.59652/aim.v3i4.521Keywords:
Artemether-lumefantrine, Plasmodium falciparum, malaria treatment failure, pediatric malaria, adherence, SudanAbstract
Artemether-lumefantrine (AL) remains the frontline therapy for uncomplicated Plasmodium falciparum malaria in Sudanese children. However, rising treatment failure rates have prompted concern. This prospective, single-arm interventional study, conducted from November 2022 to May 2023 at Wad-Medani Pediatric Teaching Hospital, investigated factors contributing to AL treatment failure. Data included clinical assessments, parasite quantification, and adherence evaluations using the Morisky Medication Adherence Scale. Key findings revealed poor adherence as a major determinant: 21% of caregivers discontinued treatment early, and 5% missed doses. High initial parasite densities were linked to delayed clearance in 10% of failures. Only 35% of patients consumed AL with fatty food, reducing drug absorption, while 6% who vomited post-dose did not receive replacements. Notably, 25% of physicians were unaware of national guidelines, and 80% lacked access to them. The study highlights the need for improved patient education and physician training to enhance treatment outcomes and curb AL failure in pediatric malaria management.
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