Clearance of Plasmodium berghei in Mice Treated with Artesunate-Amodiaquine-Iron and Artesunate-Amodiaquine Combinations

Abstract

Malaria remains a significant health burden in malaria-endemic regions, particularly in sub-Saharan Africa. Artemisinin-based combination therapies (ACTs) effectively clear malaria parasites and prevent anemia. Iron supplementation supports red blood cell production, but its impact on early malaria parasite dynamics when combined with ACTs remains underexplored. This study investigated the effect of iron supplementation on early parasite clearance in a murine model. Fourteen male Swiss mice were infected with Plasmodium berghei and randomized into two groups. One group received artesunate-amodiaquine (AS-AQ) and iron supplementation, while the other received AS-AQ only. Parasite densities were monitored six-hourly for 72 hours using Giemsa-stained thin blood films. Packed cell volume (PCV) and weight were evaluated at baseline and every 24 hours. Data was analyzed using SPSS version 22 and GraphPad Prism version 5. Parasite clearance was more rapid in the AS-AQ-Fe group, with a half-life of 12.3 hours compared to 40.8 hours in the AS-AQ group (P < 0.001). The AS-AQ group exhibited an early rise in parasitemia (parasite density), which was absent in the AS-AQ-Fe group. PCV increased significantly in the AS-AQ-Fe group (63.6 ± 2.6%) compared to the AS-AQ group (24.0 ± 4.9%; P < 0.001). Weight gain was also significantly higher in the AS-AQ-Fe group (P = 0.013). Iron supplementation with ACT significantly enhanced parasite clearance and improved hematological and weight parameters in P. berghei infected mice. Further research is needed to elucidate the underlying mechanisms to support this observation.