Efficacy of chloroquine and sulfadoxine/pyrimethamine for the treatment of uncomplicated falciparum malaria in Koumantou, Mali.

Hdl Handle:
http://hdl.handle.net/10144/17277
Title:
Efficacy of chloroquine and sulfadoxine/pyrimethamine for the treatment of uncomplicated falciparum malaria in Koumantou, Mali.
Authors:
de Radiguès, X; Diallo, K I; Diallo, M; Ngwakum, P A; Maiga, H; Djimdé, A; Sacko, M; Doumbo, O; Guthmann, J P
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
We report the results of an in vivo antimalarial efficacy study with chloroquine (CQ) and sulfadoxine/pyrimethamine (SP) conducted between 2003 and 2004 in Koumantou, southern Mali. A total of 244 children were included in the study; 210 children were followed-up for 28 days according to WHO recommendations, with PCR genotyping to distinguish late recrudescence from re-infection. Global failure proportions at Day 14, without taking into account re-infections, were 44.2% (95% CI 34.9-53.5%) in the CQ group and 2.0% (95% CI 0.0-4.8%) in the SP group. PCR-adjusted failure proportions at Day 28 were even higher in the CQ group (90.5% (95/105), 95% CI 84.8-96.2%) and relatively low in the SP group (7.0% (7/100), 95% CI 1.9-12.1%). These results show that CQ is no longer efficacious in Koumantou. The use of SP in monotherapy is likely to compromise its efficacy. We recommend the use of artemisinin-based combination therapy as first-line treatment for uncomplicated Plasmodium falciparum malaria in Koumantou.
Affiliation:
Epicentre, 42 bis, Boulevard Richard Lenoir, 75011 Paris, France. xderadigues@epicentre.msf.org
Publisher:
Elsevier
Issue Date:
Nov-2006
URI:
http://hdl.handle.net/10144/17277
DOI:
10.1016/j.trstmh.2006.03.004
PubMed ID:
16765395
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.authorde Radiguès, X-
dc.contributor.authorDiallo, K I-
dc.contributor.authorDiallo, M-
dc.contributor.authorNgwakum, P A-
dc.contributor.authorMaiga, H-
dc.contributor.authorDjimdé, A-
dc.contributor.authorSacko, M-
dc.contributor.authorDoumbo, O-
dc.contributor.authorGuthmann, J P-
dc.date.accessioned2008-01-31T16:05:26Z-
dc.date.available2008-01-31T16:05:26Z-
dc.date.issued2006-11-
dc.identifier.citationEfficacy of chloroquine and sulfadoxine/pyrimethamine for the treatment of uncomplicated falciparum malaria in Koumantou, Mali. 2006, 100 (11):1013-8 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid16765395-
dc.identifier.doi10.1016/j.trstmh.2006.03.004-
dc.identifier.urihttp://hdl.handle.net/10144/17277-
dc.description.abstractWe report the results of an in vivo antimalarial efficacy study with chloroquine (CQ) and sulfadoxine/pyrimethamine (SP) conducted between 2003 and 2004 in Koumantou, southern Mali. A total of 244 children were included in the study; 210 children were followed-up for 28 days according to WHO recommendations, with PCR genotyping to distinguish late recrudescence from re-infection. Global failure proportions at Day 14, without taking into account re-infections, were 44.2% (95% CI 34.9-53.5%) in the CQ group and 2.0% (95% CI 0.0-4.8%) in the SP group. PCR-adjusted failure proportions at Day 28 were even higher in the CQ group (90.5% (95/105), 95% CI 84.8-96.2%) and relatively low in the SP group (7.0% (7/100), 95% CI 1.9-12.1%). These results show that CQ is no longer efficacious in Koumantou. The use of SP in monotherapy is likely to compromise its efficacy. We recommend the use of artemisinin-based combination therapy as first-line treatment for uncomplicated Plasmodium falciparum malaria in Koumantou.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.meshAntimalarialsen
dc.subject.meshArtemisininsen
dc.subject.meshChloroquineen
dc.subject.meshDrug Combinationsen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMalaria, Falciparumen
dc.subject.meshMaleen
dc.subject.meshPyrimethamineen
dc.subject.meshRecurrenceen
dc.subject.meshSesquiterpenesen
dc.subject.meshSulfadoxineen
dc.subject.meshTreatment Failureen
dc.titleEfficacy of chloroquine and sulfadoxine/pyrimethamine for the treatment of uncomplicated falciparum malaria in Koumantou, Mali.en
dc.contributor.departmentEpicentre, 42 bis, Boulevard Richard Lenoir, 75011 Paris, France. xderadigues@epicentre.msf.orgen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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