Simvastatin Modulates Parasitological Response to Sulfadoxine-Pyrimethamine in Acute Uncomplicated Malaria

Ndubuisi N. Nwobodo¹* and Paul O. Okonkwo²

¹Department of Pharmacology and Therapeutics, Ebonyi State University, Abakaliki, Nigeria. ²Department of Pharmacology and Therapeutics, University of Nigeria.

ABSTRACT: Mutations in parasite enzymes and sub-optimal dosing associated with poor quality drug administration are considered major causes of parasitological resistance to sulfadoxine-pyrimethamine in the treatment of malaria. This study evaluated the effects of simvastatin in modulating parasitological response to sulfadoxine-pyrimethamine in the treatment of malaria. Malaria patients (n=60) diagnosed by thick blood film and confirmed using immunological tests were selected and informed written consent obtained. Patients were categorized into simvastatin plus sulfadoxine-pyrimethamine (test) and sulfadoxine-pyrimethamine alone (control group). The University of Nigeria Teaching Hospital Research Ethics Committee reviewed the proposal and provided ethical clearance certification (NHREC/05/01/2008B). The WHO criteria was adopted in the assessment of parasitological response and patients followed up on days D0, D3, D7, D14 and D28 post-treatment. The analysis of data was done using GraphPad Prism 4.0 and data presented in tabular and graphical forms. Revealed a statistically significant difference in parasitological response (p<0.05) between test and control groups. The mean value of low level resistance, RI was given as 8.5±0.76%, mid-level resistance, RII as 7.7±0.82%, high level parasitological resistance, RIII as 5.2±0.35% and the late parasitological failure, LPF as 3.4±0.29% in the test group. This contrasts with the value of RI given as 17.1±0.61%, RII as 22.6±0.85%, RIII as 15.2±0.76% and the LPF given as 11.4±0.15% in the control group. The implication of present study indicates that the enhanced parasitological response to sulfadoxine-pyrimethamine may be attributed to modulating effects of simvastatin use.

KEYWORDS: HMG-CoA reductase inhibitor; Malaria; Parasite resistance; Parasitological response; Plasmodium falciparum; Simvastatin

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