3-Hydroxy-3-methyl glutaryl coenzyme A reductase inhibitor modulates parasitological response to artesunate in falciparum malaria

Abstract

Statin treatment has been reported to inhibit in vitro growth of Plasmodium falciparum.  This study examines the effects of the 3-HMG CoA reductase inhibitor, simvastatin in altering and enhancing parasitological response to artesunate. 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 in line with WHO criteria. Graphpad Prism version 4.0 was employed in the analysis of data. Results revealed statistically significant difference in parasitological response between test and control groups (p<0.05). The low level resistance, RI given as 0±0.0%, mid-level resistance RII as 0±0.0%, high level parasitological resistance, RIII as 0.5±0.08% and the late parasitological failure (LPF) as 1.4±0.12% in the test group. The consideration of LPF alongside  gives an overall parasitological resistance of  1.9±0.13% in the test group. The above contrasts with RI given as 4.6±0.18%, RII as 6.4±0.31%, RIII  as 2.7±0.15%  and the LPF given as 5.6±0.17% in the control group. Thus, the consideration of LPF alongside gives an overall parasitological resistance of 19.3±0.44% in the control group. In conclusion, the main implication of the foregoing is that the HMG-CoA reductase inhibitor, simvastatin in combination with artesunate exerts modulating influence on parasitological response to antimalarial therapy.