Current Status On Artemisinin Resistance: The Kenyan Narrative

Abstract

Antimalarial drug resistance threatens the gains made on malaria elimination as per the United Nations’ sustainable development goals. Emergence if artemisinin resistance ahs been observed in part of the greater Mekong region hence frequent monitoring should be done in areas endemic for malaria. Mapping the prevalence and occurrence of mutation in Africa and Kenya in particular is important for resistance management.Electronic databases were searched for randomized clinical trials evaluating the efficacy of artemisinin combination therapy. Independent reviewers assessed the quality of the trials selected, calculated the risk of bias and a Jadad score assigned t all the trials reviewed.Seven (7 ) randomized clinical trials that evaluated the efficacy of both Artemisinin Lumefantrine and Dihydroartemisin Piperaquine were identified. The median parasite clearance rates in these studies were 2.3 hours(IQR 2.0-2.9) for Artemether Lumefantrine and 2.2 hours(IQR 1.9-2.5) for Dihydroartemisin piperaquine. Although some non-synonymous mutations were reported in some of these studies, no evidence of mutation associated with resistance to pk13 was reported.The efficacy of AL and DP is still high in Africa and particularly Kenya with no reported incidences of failure. However, continuous monitoring needs to be done so as to inform policy on interventions and treatment regimen of uncomplicated malaria in Kenya.