Evaluation Of The Effects Of Lumefantrine Component Of Coartem On Electrical Conductivity Of The Heart In Patients Taking Coartem In Management Of Uncomplicated Malaria In Klu-Th Bushenyi Dis

ABSTRACT

Background: Approximately 2.37 billion people Jive in areas at risk for transmission Of pfalciparum

malaria, mainly in sub-Saharan Africa (Hay, et al., 2009).

Combination Artemether/Lumefantrine (Coartem, Riamet, and Falcynate-LF) is a fixed dose Artemisininbased

combination therapy (ACT) indicated for the treatment of acute uncomplicated Plasmodium

Jalciparum malaria. It is an effective and well tolerated treatment providing high cure rates even in areas

with multi-drug resistance. Cardiac effect on electrical conductivity in terms of QTc prolongation and

arrhythmias remains a matter of worry (Lefevre, et al., 2001).

Aim: Several unrelated drugs have pro-arrhythmic activity associated with an ability to prolong the QTinterval

of the Electrocardiogram just as proved for Halofantrine (Nosten, et al., 1993).

Lumefantrine has some chemical similarities to Halofantrin,(Jatakiya,et al.,2014),an antimalarial known

for QTc prolongation and due to their structural similarities, also the cardiac effect on electrical

conductivity of the heart by Lumefantrine remains a matter of debate in therapeutics. This research aimed

at evaluating the effects of Lumefantrine component of coartem on electrical conductivity of the heart in

patients taking coartem in management of malaria in KIU-TH Bushenyi District.

Method: The research was a quantitative prospective random study. Safety assessment was done by

monitoring vital signs, blood pressure, Heart rate and monitoring of Electrical conductivity.

Electrocardiograms were recorded before dosing and after the fifth dose. The QT interval and Heart rate

were used to calculate QTc interval using Bazett's formula QTc=QT/RR112.The QTc interval as the

response variable was compared between treatments.

Results; In the baseline electrocardiograms the QTc intervals were normaL

There was no clinically relevant differences in the QTc intervals observed after sequential administration of Artemether/Lumefantrine(Coartem). No significant observation suggestive of cardiotoxicity was noted in the study.

Conclusion; The alternative hypothesis stating that Artemether /Lumefantrine possesses significant effect

on electrical conductivity of the heart has not been supported by the results obtained in this study.

Artemether/Lumefantrine can be used as a therapeutic option with likely better patient compliance in the treatment of uncomplicated  falciparummalaria.