Efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Northeast Ethiopia.

Background: The impact of resistance to antimalarials is insidious and unless efficacy studies are conducted, resistance may go unrecognized. The aim of this study was to assess the efficacy of artemether/lumefantrine, for the treatment of uncomplicated Plasmodium falciparum infections in Kemisie Health Center, Northeast Ethiopia. Methods: Artemether/lumefantrine efficacy study was conducted in Kemisie Health Center, Northeast Ethiopia from September, 2012 to May, 2013. The study participants were febrile people above the age of 6 months with confirmed uncomplicated P. falciparum infection. Patients were treated with artemether/lumefantrine. Clinical and parasitological parameters were monitored over a 28 days follow-up period to evaluate drug efficacy. The Kaplan–Meier method was used for statistical analysis of data on drug efficacy. Results: Among the 66 enrolled participants 72.7% were 15 and above years of age while 15.3% were less than 5 years old. Of these study participants, 53% were male. There was 89.4% fever clearance and 84.8% parasite clearance on day 1, whereas, there was 100% fever clearance and 96.8% parasite clearance on day 3 from the 62 participants who carried on the study. Among 66 participants who had started 28 days of follow-up one patient had an early parasitological failure (parasitemia on day 3) and another patient had a late parasitological failure (parasitemia on day 21). Conclusions: In general, this study discovered good clinical and parasitological response of P. falciparum to artemether/lumefantrine. Further polymeric chain reaction and plasma drug concentration based effectiveness study of artemether/ lumefantrine should be conducted throughout the country.

Syndromic management approach and wet mount microscopy of trichomonas vaginalis in pregnant women and sexually transmitted infection clinic attendants in Merawi Health Center, Merawi, Amhara Regional State, Ethiopia.

Background: Trichomonas vaginalis is a flagellated single cell protozoan parasite, which carries the distinction of being the only truly sexually transmitted parasitic infection in humans. Aim: To determine the prevalence of Trichomonas vaginalis among pregnant women and sexually transmitted infection clinic attendants in Merawi Health center. Syndromic management approach was also evaluated for its effective diagnosis of trichomoniasis. Methodology: In this study, a total of 222 women were enrolled. Majority of them were in the age group of 15-25 years (48.6%, 108). Identification of the Trichomonas vaginalis trophozoites was performed by wet mount microscopy of vaginal samples (vaginal discharge and vaginal swab) and clinical diagnosis by the syndromic management approach was performed by health workers in the health center. Result: Syndromic management approach has identified 4 women (1.8%) who had selfreported symptoms related to trichomoniasis. However, the laboratory wet mount diagnosis has identified 14 (6.3%) women who were positive for the trophozoites of Trichomonas vaginalis. The sensitivity of syndromic management approach with respect to the wet mount microscopy was 21.4%. Conclusion: Syndromic management approach is highly insensitive in screening out trichomoniasis, even, as compared with the less sensitive laboratory test (wet mount microscopy). Hence, we support the need for improved diagnostic parameters to reduce adverse trichomoniasis associated reproductive health outcomes.