Antimalarial efficacy of chloroquine, amodiaquine, sulfadoxine-pyrimethamine, and the combinations of amodiaquine + artesunate and sulfadoxine-pyrimethamine + artesunate in Huambo and Bie provinces, central Angola.

Hdl Handle:
http://hdl.handle.net/10144/16873
Title:
Antimalarial efficacy of chloroquine, amodiaquine, sulfadoxine-pyrimethamine, and the combinations of amodiaquine + artesunate and sulfadoxine-pyrimethamine + artesunate in Huambo and Bie provinces, central Angola.
Authors:
Guthmann, J P; Ampuero, J; Fortes, F; Van Overmeir, C; Gaboulaud, V; Tobback, S; Dunand, J; Saraiva, N; Gillet, P; Franco, J; Denoncin, A; Van Herp, M; Balkan, S; Dujardin, J C C; D'Alessandro, U; Legros, D
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
We studied three antimalarial treatments in Caala and Kuito, Angola, in 2002 and 2003. We tested chloroquine (CQ), amodiaquine (AQ) and sulfadoxine-pyrimethamine (SP) in Caala, and AQ, SP and the combinations AQ+artesunate (AQ+AS) and SP+artesunate (SP+AS) in Kuito. A total of 619 children (240 in Caala, 379 in Kuito) with uncomplicated Plasmodium falciparum malaria were followed-up for 28 days, with PCR genotyping to distinguish recrudescence from reinfection. PCR-corrected failure proportions at day 28 were very high in the CQ group (83.5%, 95% CI 74.1-90.5), high in the SP groups (Caala: 25.3%, 95% CI 16.7-35.8; Kuito: 38.8%, 95% CI 28.4-50.0), around 20% in the AQ groups (Caala: 17.3%, 95% CI 10.0-27.2; Kuito: 21.6%, 95% CI 14.3-30.6) and very low in the artemisinin-based combination groups (1.2%, 95% CI 0.0-6.4 for each combination AQ+AS and SP+AS). These results show that CQ and SP are no longer efficacious in Caala and Kuito and that the moderate efficacy of AQ is likely to be compromised in the short term if used as monotherapy. We recommend the use of AQ with AS, though this combination might not have a long useful therapeutic life because of AQ resistance.
Affiliation:
Epicentre, 42 bis, Boulevard Richard Lenoir, 75011 Paris, France. jguthmann@epicentre.msf.org
Publisher:
Elsevier
Issue Date:
Jul-2005
URI:
http://hdl.handle.net/10144/16873
DOI:
10.1016/j.trstmh.2004.11.010
PubMed ID:
15876443
Additional Links:
http://www.sciencedirect.com/science/journal/00359203
Language:
en
ISSN:
0035-9203
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorGuthmann, J P-
dc.contributor.authorAmpuero, J-
dc.contributor.authorFortes, F-
dc.contributor.authorVan Overmeir, C-
dc.contributor.authorGaboulaud, V-
dc.contributor.authorTobback, S-
dc.contributor.authorDunand, J-
dc.contributor.authorSaraiva, N-
dc.contributor.authorGillet, P-
dc.contributor.authorFranco, J-
dc.contributor.authorDenoncin, A-
dc.contributor.authorVan Herp, M-
dc.contributor.authorBalkan, S-
dc.contributor.authorDujardin, J C C-
dc.contributor.authorD'Alessandro, U-
dc.contributor.authorLegros, D-
dc.date.accessioned2008-01-25T14:53:40Z-
dc.date.available2008-01-25T14:53:40Z-
dc.date.issued2005-07-
dc.identifier.citationAntimalarial efficacy of chloroquine, amodiaquine, sulfadoxine-pyrimethamine, and the combinations of amodiaquine + artesunate and sulfadoxine-pyrimethamine + artesunate in Huambo and Bie provinces, central Angola. 2005, 99 (7):485-92 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid15876443-
dc.identifier.doi10.1016/j.trstmh.2004.11.010-
dc.identifier.urihttp://hdl.handle.net/10144/16873-
dc.description.abstractWe studied three antimalarial treatments in Caala and Kuito, Angola, in 2002 and 2003. We tested chloroquine (CQ), amodiaquine (AQ) and sulfadoxine-pyrimethamine (SP) in Caala, and AQ, SP and the combinations AQ+artesunate (AQ+AS) and SP+artesunate (SP+AS) in Kuito. A total of 619 children (240 in Caala, 379 in Kuito) with uncomplicated Plasmodium falciparum malaria were followed-up for 28 days, with PCR genotyping to distinguish recrudescence from reinfection. PCR-corrected failure proportions at day 28 were very high in the CQ group (83.5%, 95% CI 74.1-90.5), high in the SP groups (Caala: 25.3%, 95% CI 16.7-35.8; Kuito: 38.8%, 95% CI 28.4-50.0), around 20% in the AQ groups (Caala: 17.3%, 95% CI 10.0-27.2; Kuito: 21.6%, 95% CI 14.3-30.6) and very low in the artemisinin-based combination groups (1.2%, 95% CI 0.0-6.4 for each combination AQ+AS and SP+AS). These results show that CQ and SP are no longer efficacious in Caala and Kuito and that the moderate efficacy of AQ is likely to be compromised in the short term if used as monotherapy. We recommend the use of AQ with AS, though this combination might not have a long useful therapeutic life because of AQ resistance.en
dc.language.isoenen
dc.publisherElsevier-
dc.relation.urlhttp://www.sciencedirect.com/science/journal/00359203-
dc.rightsArchived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.aspen
dc.subject.meshAmodiaquineen
dc.subject.meshAngolaen
dc.subject.meshAnimalsen
dc.subject.meshAntimalarialsen
dc.subject.meshArtemisininsen
dc.subject.meshChild, Preschoolen
dc.subject.meshChloroquineen
dc.subject.meshDrug Combinationsen
dc.subject.meshDrug Therapy, Combinationen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMalaria, Falciparumen
dc.subject.meshMaleen
dc.subject.meshPlasmodium falciparumen
dc.subject.meshPyrimethamineen
dc.subject.meshSesquiterpenesen
dc.subject.meshSulfadoxineen
dc.subject.meshTreatment Failureen
dc.titleAntimalarial efficacy of chloroquine, amodiaquine, sulfadoxine-pyrimethamine, and the combinations of amodiaquine + artesunate and sulfadoxine-pyrimethamine + artesunate in Huambo and Bie provinces, central Angola.en
dc.contributor.departmentEpicentre, 42 bis, Boulevard Richard Lenoir, 75011 Paris, France. jguthmann@epicentre.msf.orgen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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