In vivo efficacy of chloroquine plus primaquine combination therapy against uncomplicated Plasmodium vivax malaria in Limu Kossa District, Jimma Zone, Southwest Ethiopia.

BACKGROUND: Plasmodium vivax is the second most common malaria parasite in Ethiopia. It has been treated with chloroquine (CQ) for the past seven decades. However, the emergence of CQ-resistant strains in the nation urged the Federal Ministry of Health of Ethiopia to review its national malaria treatment guideline in 2018. In the revised guideline, the first-line treatment for uncomplicated P. vivax infection is a combination of CQ and primaquine (PQ). Thus, the present study was designed to evaluate the in vivo efficacy of CQ and PQ combination therapy against clinical P. vivax mono-infection in one of the malaria-endemic areas of Ethiopia. METHODS: An open-label prospective clinical trial was conducted in the Limmu Kossa District, Jimma zone, Southwest Ethiopia, from September 2023 to March 2024. A total of 108 patients were recruited for the study. All participants received treatment with CQ at a dosage of 25 mg/kg over three days, followed by PQ at 0.25 mg/kg for 14 consecutive days. Patients were monitored for 42 days for any signs of treatment failure and malaria clinical symptoms, as per the World Health Organization (WHO) guidelines for anti-malarial drug evaluation. Additionally, haemoglobin (Hb) levels, body temperature, any adverse events, and signs of haemolysis were assessed. Data was analysed using R-software (version 4.0.0) and a significant level was considered at p < 0.05. RESULTS: The median age of the patients was 23 years, ranging from 2.5 to 62 years. Of the 108 patients initially recruited, 100 completed the 42-day follow-up period. The combination therapy of CQ and PQ for uncomplicated clinical P. vivax malaria demonstrated excellent therapeutic efficacy, with a 100% cure rate observed at both day 28 and day 42. Additionally, the recommended low dose of PQ (0.25 mg/kg) was well-tolerated, with no signs of. Additionally, most common malaria symptoms were disappeared early in the follow-up period. CONCLUSION: The combination of CQ plus PQ has exhibited excellent efficacy against uncomplicated P. vivax malaria mono-infections. To preserve this efficacy, it is critical to ensure patients adhere to the full course of PQ treatment, despite its extended duration. Therefore, health authorities should put emphasis on the boosting of the public on the importance of finishing the prescribed medication regimen.

Prevalence and Determinants of Soil-Transmitted Helminthic Infections among School Children at Goro Primary School, South West Shewa, Ethiopia.

BACKGROUND: Soil-transmitted helminths (STH)/geohelminths are human parasitic nematodes which need soil contact for their egg development and become infectious. It is widely prevalent in developing countries. In Ethiopia, too, the same problem exists although the prevalence varies from place to place depending on the presence of risk factors and hygienic status of the community. Therefore, the current study is designed to assess the prevalence and determinants of STH among school children at Goro Primary School of Southwest Ethiopia. METHODS: A cross-sectional study design was employed from April to June 2019. The stool samples were collected in prelabeled, clean, and leak-proof stool cups and examined immediately. Direct wet mount and formalin ether concentration techniques were utilized to detect the STHs in a stool sample collected from all study subjects. A total of 387 stool samples were analyzed. Moreover, community- and individual-level risk factors associated with STH infection were assessed using semistructured questionnaire. RESULTS: The overall prevalence of soil-transmitted helminth infections observed at the study area was 15.8% (n = 61/387). Among these, the most abundant STH parasite was hookworms (n = 39/61, 63.93%) followed by Ascaris lumbricoides (n = 22/61, 36.06%). Factors independently associated with soil-transmitted helminth infections were children from illiterate mother (AOR = 2.3, 95% CI: 1.1-4.8, P = 0.021), lack of habit of wearing shoes (AOR = 4.1, 95% CI: 2.0-8.5, P < 0.001), lack of frequent handwashing practice before meal (AOR = 2.3, 95% CI: 1.2-4.5, P = 0.019), use of unprotected drinking water (AOR = 39, CI:3.9-393, P = 0.002), and presence of dirt in their fingernails (AOR = 3.5, 95% CI: 1.8-6.9, P < 0.001). CONCLUSIONS: STH infection observed in the study area could be classified into the low-risk area group (according to the World Health Organization classification) calling for none or case-by-case treatment. Thus, enhancing awareness of the community in the study area on how to keep personal hygiene and environmental sanitation is quite important to keep the burden to a controllable level, besides implementation of regular deworming program in the locality.