Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa

Authors

  • Moussa Djimde Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali https://orcid.org/0000-0002-1820-2917
  • Kassoum Kayentao Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
  • Japhet Kabalu Tshiongo Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
  • Bakary Fofana Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
  • Charles Arama Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
  • Sodiomon B Sirima Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
  • Jean Bosco Ouedraogo Institut des Sciences et des Techniques Bobo Dioulasso (INSTech-Bobo), Burkina Faso
  • Abdoul Habib Beavogui Centre National de Formation et de Recherche en Santé Rurale (CNFRSR), Mafinrinha, Guinea
  • Issaka Sagara Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
  • Alassane Dicko Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
  • Petra F Mens Amsterdam University Medical Centre, Academic Medical Centre at the University of Amsterdam (AMC), Amsterdam, The Netherlands
  • Henk DFH Schallig Amsterdam University Medical Centre, Academic Medical Centre at the University of Amsterdam (AMC), Amsterdam, The Netherlands
  • Abdoulaye Djimde Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali

DOI:

https://doi.org/10.3855/jidc.17089

Keywords:

malaria, neutrophils, artemisinin-based combination therapy, West Africa

Abstract

Introduction: Polymorphonuclear neutrophils (PMN) are involved in pathogen clearance by phagocytosis. However, the role of PMNs in the efficacy of artemisinin-based combination therapy (ACT) is poorly understood.

Methodology: In a prospective longitudinal in vivo study, neutrophil rates were compared with malaria carriage after treatment with different ACTs: Artemether - lumefantrine (AL), Artesunate - amodiaquine (ASAQ), Dihydroartemisinin - piperaquine (DP) or Pyronaridine artesunate (PA). The study cases were classified as having neutropenia, normal neutrophil levels or neutrophilia depending on the level of neutrophils in the blood. This study included 3148 patients and was analyzed using R.

Results: On day 7, only four patients in the neutropenia group and treated with AL had a malaria positive blood smear based on microscopy. On day 28, the rate of recurrent parasitemia in the AL arm was significantly higher in neutropenia patients (50.9%) than in patients with normal rates of neutrophils (43.1%) or in those with neutrophilia (6.0%) (p < 0.001). In ASAQ arm, the rate of recurrent Plasmodium falciparum parasitemia was 58.8% in the neutropenia group versus 29.4% in patients with normal rates of neutrophils and 11.8% in patients with neutrophilia (p < 0.001). No patient treated with DP with normal neutrophil counts or neutrophilia was carrying malaria parasites on day 28. Among the 15 patients with parasitemia on day 28 in the PA arm, 11 (73.33%) had neutropenia while 4 (26.67%) had a normal neutrophil count (p < 0.001).

Conclusions: Patients with neutropenia had higher rates of recurrent P. falciparum parasitemia after ACT.

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Published

2023-09-30

How to Cite

1.
Djimde M, Kayentao K, Tshiongo JK, Fofana B, Arama C, Sirima SB, Ouedraogo JB, Beavogui AH, Sagara I, Dicko A, Mens PF, Schallig HD, Djimde A (2023) Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa. J Infect Dev Ctries 17:1337–1345. doi: 10.3855/jidc.17089

Issue

Vol. 17 No. 09: September 2023

Section

Original Articles

License

Copyright (c) 2023 Moussa Djimde, Kassoum Kayentao, Kabalu, Bakary Fofana, Charles Arama, Sodiomon B Sirima, Jean Bosco Ouedraogo, Abdoul Habib Beavogui, Issaka Sagara, Alassane Dicko, Petra F. Mens, Henk D. F. H. Schallig, Abdoulaye Djimde

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