Efficacy of chloroquine, sulfadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad.

Hdl Handle:
http://hdl.handle.net/10144/17279
Title:
Efficacy of chloroquine, sulfadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad.
Authors:
Grandesso, F; Bachy, C; Donam, I; Ntambi, J; Habimana, J; D'Alessandro, U; Maikere, J; Vanlerberghe, V; Kerah, C H; Guthmann, J P
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
We report two 28-day in-vivo antimalarial efficacy studies carried out in the urban centres of Bongor and Koumra, southern Chad. We assess chloroquine (CQ), sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) to treat Plasmodium falciparum uncomplicated malaria. Methods and outcome classification complied with latest WHO guidelines. Out of the 301 and 318 children aged 6-59 months included in Bongor and Koumra, respectively, 246 (81.7%) and 257 (80.8%) were eligible for analysis. In Bongor and Koumra, the 28-day PCR-adjusted failure rates for CQ were 23.7% (95% CI 14.7-34.8%) and 32.9% (95% CI 22.1-45.1%), respectively, and those for SP were 16.3% (95% CI 9.4-25.5%) and 4.3% (95% CI 1.2-10.5%). AQ failure rates were 6.4% (95% CI 2.1-14.3%) and 2.2% (95% CI 0.3-7.6%). The current use of CQ in Bongor and Koumra is questionable, and a more efficacious treatment is needed. Considering the reduced efficacy of SP in Bongor, AQ seems to be the best option for the time being. Following WHO recommendations that prioritize the use of artemisinin-based combinations, artesunate plus amodiaquine could be a potential first-line treatment. Nevertheless, the efficacy of this combination should be evaluated and the change carefully prepared, implemented and monitored.
Affiliation:
Epicentre, 8 Rue Saint Sabin, 75011 Paris, France. francesco.grandesso@epicentre.msf.org
Publisher:
Elsevier
Issue Date:
May-2006
URI:
http://hdl.handle.net/10144/17279
DOI:
10.1016/j.trstmh.2005.07.017
PubMed ID:
16297419
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.authorGrandesso, F-
dc.contributor.authorBachy, C-
dc.contributor.authorDonam, I-
dc.contributor.authorNtambi, J-
dc.contributor.authorHabimana, J-
dc.contributor.authorD'Alessandro, U-
dc.contributor.authorMaikere, J-
dc.contributor.authorVanlerberghe, V-
dc.contributor.authorKerah, C H-
dc.contributor.authorGuthmann, J P-
dc.date.accessioned2008-01-31T16:10:04Z-
dc.date.available2008-01-31T16:10:04Z-
dc.date.issued2006-05-
dc.identifier.citationEfficacy of chloroquine, sulfadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad. 2006, 100 (5):419-26 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid16297419-
dc.identifier.doi10.1016/j.trstmh.2005.07.017-
dc.identifier.urihttp://hdl.handle.net/10144/17279-
dc.description.abstractWe report two 28-day in-vivo antimalarial efficacy studies carried out in the urban centres of Bongor and Koumra, southern Chad. We assess chloroquine (CQ), sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) to treat Plasmodium falciparum uncomplicated malaria. Methods and outcome classification complied with latest WHO guidelines. Out of the 301 and 318 children aged 6-59 months included in Bongor and Koumra, respectively, 246 (81.7%) and 257 (80.8%) were eligible for analysis. In Bongor and Koumra, the 28-day PCR-adjusted failure rates for CQ were 23.7% (95% CI 14.7-34.8%) and 32.9% (95% CI 22.1-45.1%), respectively, and those for SP were 16.3% (95% CI 9.4-25.5%) and 4.3% (95% CI 1.2-10.5%). AQ failure rates were 6.4% (95% CI 2.1-14.3%) and 2.2% (95% CI 0.3-7.6%). The current use of CQ in Bongor and Koumra is questionable, and a more efficacious treatment is needed. Considering the reduced efficacy of SP in Bongor, AQ seems to be the best option for the time being. Following WHO recommendations that prioritize the use of artemisinin-based combinations, artesunate plus amodiaquine could be a potential first-line treatment. Nevertheless, the efficacy of this combination should be evaluated and the change carefully prepared, implemented and monitored.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.meshAnimalsen
dc.subject.meshChaden
dc.subject.meshChild, Preschoolen
dc.subject.meshChloroquineen
dc.subject.meshDrug Combinationsen
dc.subject.meshDrug Resistanceen
dc.subject.meshDrug Therapy, Combinationen
dc.subject.meshGenes, Protozoanen
dc.subject.meshGenotypeen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMalaria, Falciparumen
dc.subject.meshParasitic Sensitivity Testsen
dc.subject.meshPlasmodium falciparumen
dc.subject.meshProspective Studiesen
dc.subject.meshPyrimethamineen
dc.subject.meshSulfadoxineen
dc.subject.meshTreatment Outcomeen
dc.subject.meshUrban Populationen
dc.titleEfficacy of chloroquine, sulfadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad.en
dc.contributor.departmentEpicentre, 8 Rue Saint Sabin, 75011 Paris, France. francesco.grandesso@epicentre.msf.orgen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen
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