Risk Factors For The Presence Of Artemisinin Antibodies Amongst Patients Undergoing Treatment For Malaria In Benin City, Nigeria

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Abstract
Artemisinin have being used for the control of malaria worldwide for over a decade and its listing by WHO as the first-line drug for treatment of both severe and uncomplicated malaria and the observed treatment failure have warranted the need to screening malaria patients for the presence of antibodies to malaria. In our locality where there is unregulated use of antimicrobials, the need to ascertain the prevalence of antibodies to artemisinin and evaluate the potential risk factors cannot be overemphasised, hence this study. Blood specimens were collected from 400 randomised patients undergoing treatment for malaria in Benin City, Nigeria. Data on socio-demography were collected with the aid of a well-structured questionnaire. Artemisinin antibodies were detected by drug absorption mechanism (DAM) and immune complex reaction (IMC) methods. ABO, rhesus blood group, and haemoglobin (Hb) phenotype were determined by using standard technique. A total of 112(28.00%) out of the 400 participants had artemisinin antibodies. Gender, marital status, level of education, residential area and living arrangement did not significantly affect the prevalence of artemisinin antibodies whereas age and ethnicity significantly affected the prevalence of artemisinin antibodies (p=0.0244 and 0.0001 respectively). Duration of the last artemisinin used and the mostly used brand of artemisinin as well as the ABO and rhesus blood groups and haemoglobin phenotypes did not significantly affect the production of artemisinin antibodies. Although of all the risk factors age and ethnicity were identified as the only risk factors for the development of artemisinin, we therefore advocate the prudent use of artemisinin-containing antimalarial and concerted efforts in combating self-medication with this drugs to avoid the development of resistance.

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