Therapeutic Efficacy of Artesunate-Amodiaquine and Polymorphism of Plasmodium Falciparumk13-Propeller Gene in Pala (Tchad)

ACTs was recommended as a first-line treatment for uncomplicated Plasmodium falciparum malaria in many malaria-endemic countries. Regular monitoring of ACTs is recommended by the World Health Organization (WHO) to help early detection of resistant parasites strains and contain their rapid spread. The aim of this study was to assess therapeutic efficacy of Artesunate-Amodiaquine (ASAQ) the first line treatment of uncomplicated falciparummalaria in Chad and analyze the polymorphism of Kelch13-propeller gene. A single-arm prospective study of a 28-days follow-up was conducted among children aged 6- 59 months with uncomplicated P. falciparum malaria at Pala site from November to December 2015.The primary outcome was ACPR PCR-corrected at day28 and the secondary endpoints were the Parasite Clearance (PCT), Fever Clearance Time (FCT) and tolerability of the drug Kelch13-propeller was amplified and sequenced in all Plasmodium falciparum isolates. A total of 58 children were enrolled and 51 reached the study endpoint. Crude Adequate and clinical response was 98% at day 28 and after correction PCR this rate was 100%. Treatment was well tolerated. No mutations neither synonymous nor non synonymous were detected on k13 gene, after alignment with the reference sequence PF3D7_1343700. ASAQ was proved to be efficacious and well tolerated in Pala children and no mutation was observed in the Kelch 13-propeller gene. Further studies are needed across the country to enhance resistance surveillance. Key Word: Malaria, P. falciparum, Artesunate-Amodiaquine, k13- propeller, Cha