By Chukwuma Muanya
CHINESE researchers say with Artequick, a fixed-dose combination of artemisinin and piperaquine, malaria can be effectively treated within 24 hours and possibly eliminated from human population in 20 years.
Clinical trails of Artequick presented, to the media, last week in Lagos by the General Manager of Artepharm Company Limited, China, Dr. Pan Longhua, concluded that Artequick is an ideal drug for the treatment of malaria, especially for drug resistant Plasmodium falciparum.
Artepharm is represented in Nigeria by Trusted Pharmacy and Chemicals West African Limited.
Results of multi-center clinical trails in China, Viet Nam, Thailand, Cambodia, Indonesia and Comoros published in Malaria Journal showed that Artequick controls the malaria symptoms rapidly. Fever Clearance Time (FCT) and Parasite Clearance Time (PCT) are 16 to 30 hours and 36 to 60 hours in that order.
Longhua said: "Artequick stops the parasite development within two hours and more than 95 per cent parasites are killed within 24 hours after the drug administration. Due to its quick action, Artequick could reduce the occurrence of severe malaria cases and also the malaria mortality.
"Artequick provides a short regimen: Two-day regimen, two tablets as the initial dose and another two tablets after 24 hours.
"Artequick has high efficacy even in multi-drug resistant Plasmodium falciparum epidemic areas. The 28-day cure rate is above 97 per cent. After two-month observation, it is found that the relapse rate of Artequick in treatment of Plasmodium vivax malaria is two per cent. The combination of artemisinin and piperaquine delays the development of drug resistance by Plasmodium falciparum.
"Artemisinin is toxic to the early embryo according to the studies in mice, therefore Artequick is contraindicated for pregnant women during the first trimester."
Artemisinin and its derivatives are a group of drugs that possess the most rapid action of all current drugs against P. falciparum malaria. According to the World Health Organisation (WHO), treatments containing artemisinin derivative artemisinin-combination therapies (ACTs) are now standard treatment worldwide for P. falciparum malaria.
The starting compound artemisinin is isolated from the plant Artemisia annua, sweet wormwood, an herb employed in Chinese traditional medicine.
Piperaquine is a bisquinoline antimalarial drug that was first synthesised in the 1960s, and used extensively in China and Indochina as prophylaxis and treatment during the next 20 years. A number of Chinese research groups documented that it was at least as effective as, and better tolerated than, chloroquine against falciparum and vivax malaria.
According to the WHO, the rationale for such ACTs was to provide an inexpensive, short-course treatment regimen with a high cure rate and good tolerability that would reduce transmission and protect against the development of parasite resistance.
According to the clinical trials, Artequick causes much fewer clinical side effects than any other artemisinin-based combinations. Nausea, vomiting, dizziness, abdominal pain and diarrhea are self-limited and only occur in less than three per cent of patients. No abnormal laboratory results of hematology, biochemistry, or Electrocardiography (ECG) were reported.
Researchers from research centre for Qinghao, Guangzhoub University of Chinese Medicine, Guanzghou China; National Centre for Parasitology, entomology and malaria control, Cambodia; and Department of Health, Kampong Speu, Cambodia in a study published in Malaria Journal concluded: "Mass drug administration with artemisinin-piperaquine and primaquine can be considered as an alternative strategy for malaria control, and, in combination with other anti-malarial measured, may provide a tool for malaria elimination and eradication.
"Malaria is one of the biggest threats to the human health, especially in African countries. Though some patients can afford and access effective antimalarial drugs, malaria still causes great harm to the population due to its special transmission characters. Therefore, a new strategy of malaria control is urgently needed in these countries to change the current situation."
Leader of the team of researchers and inventor of Artequick, Prof. Li Guoqiao, is engaged in promoting a new strategy of malaria control, Fast Elimination of Malaria by Source Eradication (FEMSE), in malaria epidemic countries such as Cambodia and Comoros and the pilot projects of FEMSE conducted in these countries have achieved significant successes.
Guoqiao wrote: "The decreasing amplitude of population parasite carriage rate in Moheli, Comoros was 98 per cent, and the parasite positive rate in mosquito vectors decreased to zero after four-month administration of FEMSE project. Furthermore, malaria mortality decreased to zero after the commencement of the FEMSE project. Artequick is the main drug used in the FEMSE project."
Guoqiao said to reduce or totally eliminate malaria parasite infections from a population, interruption of parasite transmission is critical. one strategy for achieving the goal, he said, is to interrupt parasite transmission through mosquito vector control such as insecticide spraying and large-scale distribution of insecticide-impregnated bed nets."
The researchers wrote: "Although some successes have been achieved through these efforts, vector control in most endemic regions has had limited success at sustained interruption of transmission, especially when applied in isolation without aggressive drug treatment and prevention strategies. "