Efficacy of chloroquine, sulphadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in Kajo Keji county, Sudan.

Hdl Handle:
http://hdl.handle.net/10144/17280
Title:
Efficacy of chloroquine, sulphadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in Kajo Keji county, Sudan.
Authors:
Stivanello, E; Cavailler, P; Cassano, F; Omar, S A; Kariuki, D; Mwangi, J; Piola, P; Guthmann, J P
Journal:
Tropical Medicine & International Health
Abstract:
To provide advice on the rational use of antimalarial drugs, Médecins Sans Frontières conducted a randomized, an open label efficacy study in Kajo Keji, an area of high transmission of malaria in southern Sudan. The efficacy of chloroquine (CQ), sulphadoxine-pyrimethamine (SP) and amodiaquine (AQ) were measured in a 28-day in vivo study, with results corrected by PCR genotyping. Of 2010 children screened, 115 children aged 6-59 months with uncomplicated Plasmodium falciparum malaria were randomized into each group to receive a supervised course of treatment. Of these, 114, 103 and 111 were analysed in the CQ, SP and AQ groups, respectively. The overall parasitological failure rates at day 28 were 93.9% [95% confidence interval (CI) 87.3-97.3] for CQ, 69.9% (95% CI 60.0-78.3) for SP, and 25.2% (95% CI 17.7-34.5) for AQ. These results provide important missing data on antimalarial drug efficacy in southern Sudan. They indicate that none of the drugs could be used in monotherapy and suggest that even in combination with artemisinin, cure rates might not be efficacious enough. We recommend a combination of artemether and lumefantrine as first-line treatment for uncomplicated P. falciparum malaria cases in Kajo Keji county.
Affiliation:
Médecins Sans Frontières, Geneva, Switzerland. elisasti@tin.it
Publisher:
Wiley-Blackwell
Issue Date:
Sep-2004
URI:
http://hdl.handle.net/10144/17280
DOI:
10.1111/j.1365-3156.2004.01290.x
PubMed ID:
15361110
Additional Links:
http://www.blackwell-synergy.com/loi/tmi
Language:
en
ISSN:
1360-2276
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorStivanello, E-
dc.contributor.authorCavailler, P-
dc.contributor.authorCassano, F-
dc.contributor.authorOmar, S A-
dc.contributor.authorKariuki, D-
dc.contributor.authorMwangi, J-
dc.contributor.authorPiola, P-
dc.contributor.authorGuthmann, J P-
dc.date.accessioned2008-01-31T16:12:00Z-
dc.date.available2008-01-31T16:12:00Z-
dc.date.issued2004-09-
dc.identifier.citationEfficacy of chloroquine, sulphadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in Kajo Keji county, Sudan. 2004, 9 (9):975-80 Trop. Med. Int. Healthen
dc.identifier.issn1360-2276-
dc.identifier.pmid15361110-
dc.identifier.doi10.1111/j.1365-3156.2004.01290.x-
dc.identifier.urihttp://hdl.handle.net/10144/17280-
dc.description.abstractTo provide advice on the rational use of antimalarial drugs, Médecins Sans Frontières conducted a randomized, an open label efficacy study in Kajo Keji, an area of high transmission of malaria in southern Sudan. The efficacy of chloroquine (CQ), sulphadoxine-pyrimethamine (SP) and amodiaquine (AQ) were measured in a 28-day in vivo study, with results corrected by PCR genotyping. Of 2010 children screened, 115 children aged 6-59 months with uncomplicated Plasmodium falciparum malaria were randomized into each group to receive a supervised course of treatment. Of these, 114, 103 and 111 were analysed in the CQ, SP and AQ groups, respectively. The overall parasitological failure rates at day 28 were 93.9% [95% confidence interval (CI) 87.3-97.3] for CQ, 69.9% (95% CI 60.0-78.3) for SP, and 25.2% (95% CI 17.7-34.5) for AQ. These results provide important missing data on antimalarial drug efficacy in southern Sudan. They indicate that none of the drugs could be used in monotherapy and suggest that even in combination with artemisinin, cure rates might not be efficacious enough. We recommend a combination of artemether and lumefantrine as first-line treatment for uncomplicated P. falciparum malaria cases in Kajo Keji county.en
dc.language.isoenen
dc.publisherWiley-Blackwell-
dc.relation.urlhttp://www.blackwell-synergy.com/loi/tmi-
dc.rightsArchived on this site with the kind permission of Wiley-Blackwellen
dc.subject.meshAmodiaquineen
dc.subject.meshAntimalarialsen
dc.subject.meshChilden
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.meshPyrimethamineen
dc.subject.meshSudanen
dc.subject.meshSulfadoxineen
dc.subject.meshTreatment Outcomeen
dc.titleEfficacy of chloroquine, sulphadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in Kajo Keji county, Sudan.en
dc.contributor.departmentMédecins Sans Frontières, Geneva, Switzerland. elisasti@tin.iten
dc.identifier.journalTropical Medicine & International Healthen

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