Evaluation of Parasite Clearance Rates and Associated Baseline Risk Factors Among Malaria-Positive Patients Receiving Treatment at Nchanga North General Hospital, Chingola, Zambia
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Delayed parasite clearance following antimalarial treatment threatens global malaria control efforts and serves as an early warning indicator for emerging drug resistance. Monitoring clearance dynamics is critical in high-burden regions to track disease burden and therapeutic efficacy. Objective To evaluate parasite clearance rates and identify baseline demographic, clinical, and parasitological risk factors associated with delayed clearance among malaria-positive patients undergoing treatment at Nchanga North General Hospital in Chingola, Zambia. Methods A prospective clinical analysis was conducted among (N = 121) confirmed malaria-positive patients receiving antimalarial therapy. The cohort primarily consisted of a pediatric population (n = 120), mean age: (5.61 ± 3.9) years, ranging from 3 months to 15 years, alongside one adult outlier (57 years). Parasite clearance times (PCTs) were calculated after treatment initiation. Delayed parasite clearance was defined according to World Health Organization (WHO) criteria as the persistence of parasitemia on Day 3 (> 72 hours). Baseline demographic factors (age, gender) and parasitological factors (baseline parasite density) were analyzed using Chi-square tests and independent sample metrics within IBM SPSS Statistics. Results The overall parasite clearance profile exhibited a pronounced right-hand skew. While the vast majority of patients successfully eliminated parasitemia within 24 to 48 hours (median: 24 hours), the mean PCT was prolonged at (36.4 ± 16.8) hours, extending to a maximum of 144 hours. On Day 3 post-treatment, 9.1% (n = 11) of the patient cohort demonstrated delayed parasite clearance, signaling potential treatment vulnerabilities. Cross-tabulation revealed that baseline demographic factors, including gender and age distribution (p > 0.05), did not statistically influence delayed clearance trajectories, with Day 3 delays distributed across infants, young children, and adolescent brackets alike. Conversely, baseline parasitological burden was a critical determinant of therapeutic velocity; patients in the delayed clearance cohort presented with profoundly elevated initial baseline parasite densities compared to normal responders. Conclusion A notable proportion (9.1%) of malaria patients at Nchanga North General Hospital experience delayed parasite clearance at Day 3. This delay is strictly driven by high baseline parasite density rather than demographic vulnerabilities such as age or gender. These findings underscore the urgent need for targeted clinical monitoring of patients presenting with hyper-parasitemia and continuous, high-vigilance surveillance to safeguard antimalarial efficacy in the region.
Source: Research Square
Institution: Northrise University
Language: English
Topic: Malaria Research and Control
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7203824280