Statin treatment enhances clinical response to artesunate in acute uncomplicated malaria

Abstract

Several reports have emerged on widespread clinical failures since the introduction of artesunate as first-line treatment for malaria. This study sought to evaluate the synergistic effects of simvastatin plus artesunate combination in antimalarial chemotherapy. Patients in attendance at primary health facilities (n=60) suffering from malaria infection were selected for the study and informed consent obtained. Ethical clearance certification was obtained (NHREC/05/01/2008B) and patients categorized into artesunate plus simvastatin (test) and artesunate alone (control) groups. The patients were followed up on days D0, D3, D7, D14 and D28 post-treatment and in line with WHO criteria. Graphpad Prism version 4.0 was employed in the analysis of data. Results revealed statistically significant difference (p<0.05) in clinical response between test and control groups involving all the parameters assessed. The post-treatment mean geometric parasite density was given as 0±0.0/µL and 139±19.0/µL in the test and control groups. The mean total treatment failure was given as 1.9±0.13% in the test group compared to 19.3±0.44% in the control. A mean parasite clearance time of 1.2±0.9 days in the test group as compared to 2.9±0.29 days in the control was reported. Mean fever clearance time of 12.1±0.8 hours and 38.6±2.8 hours were reported in the test and control groups. The recrudescence rate of 1.1±0.05% given in the test differed from 8.7±0.09% given in the control. Consequently, simvastatin plus artesunate may be considered as novel approach for combinational therapy aimed at enhancing clinical response to artesunate.