IMPACT OF ORANGE JUICE ON THE ANTI-MALARIAL ACTIVITTY OF ARTEMETHER-LUMEFANTRINE IN PLASMODIUM INDUCED SWISS ALBINO MICE

ABSTRACT Malaria remains a major global health challenge, particularly in sub-Saharan African region, where the burden is highest affecting vulnerable populations such as children, pregnant women, and immuno-compromised individuals. In 2022, the World Health Organization reported 249 million malaria cases and 608,000 deaths. While early treatments like quinine and synthetic drugs were effective, drug resistance led to the development of artemisinin-based combination therapies, which improved treatment outcomes but still face challenges such as emerging resistance. Artemether-lumefantrine (AL) is a widely used artemisinin-based combination therapy, is a cornerstone in malaria treatment. However, the potential for dietary interactions, such as with orange juice, which is rich in bioactive compounds such as ascorbic acid, can influence the pharmacokinetics and pharmacodynamics of antimalarial drugs by altering absorption, metabolism, and drug transporters, potentially affecting their efficacy. This study investigated the impact of orange juice on the anti-malarial activity of AL using Swiss albino mice infected with Plasmodium berghei. The mice were divided into 13 groups, receiving varying doses of AL and orange juice, either alone or in combination. Key parameters, including parasitemia levels, hematological indices, antioxidant enzyme activities, and lipid peroxidation markers, were evaluated. The results demonstrated a dose-dependent interaction between AL and orange juice. Higher doses of orange juice reduced AL’s efficacy, delaying plasmodium clearance, while lower doses potentiated AL’s anti-malarial activity, achieving faster parasite clearance compared to AL alone. Additionally, co-administration of orange juice at higher doses improved hematological parameters and antioxidant enzyme activities, mitigating oxidative stress induced by malaria and AL treatment. Findings highlight the dual impact of orange juice on AL therapy, suggesting that dietary components can modulate drug efficacy. This indicates the need for patient education on dietary habits during antimalarial treatment and further research to elucidate the mechanisms underlying these interactions.