Artemisia annua dried leaf tablets treated malaria resistant to ACT and i.v. artesunate: Case reports
Open accessAbstract
Background Dried leaf Artemisia annua (DLA) has shown efficacy against Plasmodium sp. in rodent studies and in small clinical trials. Rodent malaria also showed resiliency against the evolution of artemisinin drug resistance.Purpose This is a case report of a last resort treatment of patients with severe malaria who were responding neither to artemisinin combination therapy (ACT) nor i.v. artesunate.Study design Of many patients treated with ACTs and i.v. artesunate during the 6 mon study period, 18 did not respond and were subsequently treated with DLA Artemisia annua.Methods Patients were given a dose of 0.5g DLA per os, twice daily for 5d. Total adult delivered dose of artemisinin was 55mg. Dose was reduced for body weight under 30kg. Clinical symptoms, e.g. fever, coma etc., and parasite levels in thick blood smears were tracked. Patients were declared cured and released from hospital when parasites were microscopically undetectable and clinical symptoms fully subsided.Results All patients were previously treated with Coartem® provided through Santé Rurale (SANRU) and following the regimen prescribed by WHO. Of 18 ACT-resistant severe malaria cases compassionately treated with DLA, all fully recovered. Of the 18, this report details two pediatric cases.Conclusions Successful treatment of all 18 ACT-resistant cases suggests that DLA should be rapidly incorporated into the antimalarial regimen for Africa and possibly wherever else ACT resistance has emerged.
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Dry leaf consumption seems resilient against the evolution of artemisinin drug resistance as shown in humans and in Plasmodium yoelii-infected mice.
“Another reason for increasing the in planta artemisinin content is that dry leaf consumption of A. annua is showing efficacy in human trials (Daddy et al. 2017; Munyangi et al. 2019) and seems resilient against the evolution of artemisinin drug resistance as maybe shown in humans (Daddy et al. 2017) and in Plasmodium yoelii -infected mice (Elfawal et al. 2015).”
From Enhancing artemisinin content in and delivery from Artemisia annua: a review of alternative, classical, and transgenic approaches (2021) · cites this paper as Daddy et al. 2017
The Conclusions report that dried-leaf Artemisia annua controlled 18 ACT-resistant malaria cases in humans. That supports possible efficacy against existing resistance, but the case reports do not establish that dry-leaf consumption slows the evolution of resistance in humans. The paper's Background attributes reduced emergence of resistance to rodent work; the citing sentence separately cites Elfawal et al. for the mice. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDry leaf consumption of A. annua is showing efficacy in human trials.
“Another reason for increasing the in planta artemisinin content is that dry leaf consumption of A. annua is showing efficacy in human trials (Daddy et al. 2017; Munyangi et al. 2019) and seems resilient against the evolution of artemisinin drug resistance as maybe shown in humans (Daddy et al. 2017) and in Plasmodium yoelii -infected mice (Elfawal et al. 2015).”
From Enhancing artemisinin content in and delivery from Artemisia annua: a review of alternative, classical, and transgenic approaches (2021) · cites this paper as Daddy et al. 2017
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- Authors
- Daddy, N. B., Kalisya, L. M., Bagire, P. G., Watt, R. L., Towler, M. J., & Weathers, P. J.
- Affiliations
- Plexision (United States) (US)
- Worcester Polytechnic Institute (US)
- Corresponding author
- Weathers, Pamela J.
- ORCID
- Weathers, Pamela J.
- Venue
- Phytomedicine
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 32
- Pages
- 37-40
- ISSN
- 0944-7113 (ISSN-L)
- PMC
- PMC5547396
- OpenAlex
- W2606166051
- Cited by
- 79
- References
- 19
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 7 · 2023: 6 · 2022: 8 · 2021: 14 · 2020: 10 · 2019: 10 · 2018: 12 · 2017: 3
- FWCI
- 8.97
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Phytomedicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health (R15AT008277)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Phytochemical compounds biological activities
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Ethnobotanical and Medicinal Plants Studies
- Keywords
- Artemisia annua, artemisinin resistance, artemisinin-based combination therapy, artesunate, severe malaria, Plasmodium, last-resort treatment, pediatric malaria, antimalarial drug resistance, artemether-lumefantrine
- MeSH terms
- Artesunate, Artemether, Lumefantrine Drug Combination, Adolescent, Adult, Antimalarials, Child, Child, Preschool, Drug Combinations, Drug Resistance, Microbial, Ethanolamines, Female, Fluorenes, Humans, Infant, Malaria, Male, Middle Aged, Tablets, Treatment Outcome, Plant Leaves, Artemisia annua, Artemisinins, Young Adult, Administration, Intravenous
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