Efficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan.

Hdl Handle:
http://hdl.handle.net/10144/17267
Title:
Efficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan.
Authors:
van den Broek, I; Amsalu, R; Balasegaram, M; Hepple, P; Alemu, E; Hussein, E B; Al-Faith, M; Montgomery, J; Checchi, F
Journal:
Malaria Journal
Abstract:
BACKGROUND: The treatment for Plasmodium falciparum malaria in Sudan has been in process of change since 2003. Preceding the change, this study aimed to determine which artemisinin-based combination therapies is more effective to treat uncomplicated malaria in Malakal, Upper Nile, Sudan. METHODS: Clinical trial to assess the efficacy of 2 antimalarial therapies to treat P. falciparum infections in children aged 6-59 months, in a period of 42 days after treatment. RESULTS: A total of 269 children were followed up to 42 days. Artesunate plus Sulfadoxine/Pyrimethamine (AS+SP) and Artesunate plus Amodiaquine (AS+AQ) were both found to be efficacious in curing malaria infections by rapid elimination of parasites and clearance of fever, in preventing recrudescence and suppressing gametocytaemia. The combination of AS+SP appeared slightly more efficacious than AS+AQ, with 4.4% (4/116) versus 15% (17/113) of patients returning with malaria during the 6-week period after treatment (RR = 0.9, 95% CI 0.81-0.96). PCR analysis identified only one recrudescence which, together with one other early treatment failure, gave efficacy rates of 99.0% for AS+AQ (96/97) and 99.1% for AS+SP (112/113). However, PCR results were incomplete and assuming part of the indeterminate samples were recrudescent infections leads to an estimated efficacy ranging 97-98% for AS+SP and 88-95% for AS+AQ. CONCLUSION: These results lead to the recommendation of ACT, and specifically AS+SP, for the treatment of uncomplicated falciparum malaria in this area of Sudan. When implemented, ACT efficacy should be monitored in sentinel sites representing different areas of the country.
Affiliation:
Manson's Unit, MSF -UK, 67-74 Saffron Hill, London EC1N, UK. ingrid.van.den.broek@london.msf.org
Publisher:
BioMed Central
Issue Date:
2005
URI:
http://hdl.handle.net/10144/17267
DOI:
10.1186/1475-2875-4-14
PubMed ID:
15730557
Additional Links:
http://www.malariajournal.com
Language:
en
ISSN:
1475-2875
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorvan den Broek, I-
dc.contributor.authorAmsalu, R-
dc.contributor.authorBalasegaram, M-
dc.contributor.authorHepple, P-
dc.contributor.authorAlemu, E-
dc.contributor.authorHussein, E B-
dc.contributor.authorAl-Faith, M-
dc.contributor.authorMontgomery, J-
dc.contributor.authorChecchi, F-
dc.date.accessioned2008-01-31T16:19:02Z-
dc.date.available2008-01-31T16:19:02Z-
dc.date.issued2005-
dc.identifier.citationEfficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan. 2005, 4 (1):14 Malar. J.en
dc.identifier.issn1475-2875-
dc.identifier.pmid15730557-
dc.identifier.doi10.1186/1475-2875-4-14-
dc.identifier.urihttp://hdl.handle.net/10144/17267-
dc.description.abstractBACKGROUND: The treatment for Plasmodium falciparum malaria in Sudan has been in process of change since 2003. Preceding the change, this study aimed to determine which artemisinin-based combination therapies is more effective to treat uncomplicated malaria in Malakal, Upper Nile, Sudan. METHODS: Clinical trial to assess the efficacy of 2 antimalarial therapies to treat P. falciparum infections in children aged 6-59 months, in a period of 42 days after treatment. RESULTS: A total of 269 children were followed up to 42 days. Artesunate plus Sulfadoxine/Pyrimethamine (AS+SP) and Artesunate plus Amodiaquine (AS+AQ) were both found to be efficacious in curing malaria infections by rapid elimination of parasites and clearance of fever, in preventing recrudescence and suppressing gametocytaemia. The combination of AS+SP appeared slightly more efficacious than AS+AQ, with 4.4% (4/116) versus 15% (17/113) of patients returning with malaria during the 6-week period after treatment (RR = 0.9, 95% CI 0.81-0.96). PCR analysis identified only one recrudescence which, together with one other early treatment failure, gave efficacy rates of 99.0% for AS+AQ (96/97) and 99.1% for AS+SP (112/113). However, PCR results were incomplete and assuming part of the indeterminate samples were recrudescent infections leads to an estimated efficacy ranging 97-98% for AS+SP and 88-95% for AS+AQ. CONCLUSION: These results lead to the recommendation of ACT, and specifically AS+SP, for the treatment of uncomplicated falciparum malaria in this area of Sudan. When implemented, ACT efficacy should be monitored in sentinel sites representing different areas of the country.en
dc.language.isoenen
dc.publisherBioMed Central-
dc.relation.urlhttp://www.malariajournal.com-
dc.rightsArchived on this site by Open Access permissionen
dc.subject.meshAmodiaquineen
dc.subject.meshAntimalarialsen
dc.subject.meshArtemisininsen
dc.subject.meshChild, Preschoolen
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.meshPyrimethamineen
dc.subject.meshSesquiterpenesen
dc.subject.meshSudanen
dc.subject.meshSulfadoxineen
dc.titleEfficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan.en
dc.contributor.departmentManson's Unit, MSF -UK, 67-74 Saffron Hill, London EC1N, UK. ingrid.van.den.broek@london.msf.orgen
dc.identifier.journalMalaria Journalen

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