Efficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan.
dc.contributor.author | van den Broek, I | |
dc.contributor.author | Amsalu, R | |
dc.contributor.author | Balasegaram, M | |
dc.contributor.author | Hepple, P | |
dc.contributor.author | Alemu, E | |
dc.contributor.author | Hussein, E B | |
dc.contributor.author | Al-Faith, M | |
dc.contributor.author | Montgomery, J | |
dc.contributor.author | Checchi, F | |
dc.date.accessioned | 2008-01-31T16:19:02Z | |
dc.date.available | 2008-01-31T16:19:02Z | |
dc.date.issued | 2005 | |
dc.identifier.citation | Efficacy 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.issn | 1475-2875 | |
dc.identifier.pmid | 15730557 | |
dc.identifier.doi | 10.1186/1475-2875-4-14 | |
dc.identifier.uri | http://hdl.handle.net/10144/17267 | |
dc.description.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. | |
dc.language.iso | en | en |
dc.publisher | BioMed Central | |
dc.relation.url | http://www.malariajournal.com | |
dc.rights | Archived on this site by Open Access permission | en |
dc.subject.mesh | Amodiaquine | en |
dc.subject.mesh | Antimalarials | en |
dc.subject.mesh | Artemisinins | en |
dc.subject.mesh | Child, Preschool | en |
dc.subject.mesh | Drug Combinations | en |
dc.subject.mesh | Drug Therapy, Combination | en |
dc.subject.mesh | Female | en |
dc.subject.mesh | Humans | en |
dc.subject.mesh | Infant | en |
dc.subject.mesh | Malaria, Falciparum | en |
dc.subject.mesh | Male | en |
dc.subject.mesh | Pyrimethamine | en |
dc.subject.mesh | Sesquiterpenes | en |
dc.subject.mesh | Sudan | en |
dc.subject.mesh | Sulfadoxine | en |
dc.title | Efficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan. | en |
dc.contributor.department | Manson's Unit, MSF -UK, 67-74 Saffron Hill, London EC1N, UK. ingrid.van.den.broek@london.msf.org | en |
dc.identifier.journal | Malaria Journal | en |
refterms.dateFOA | 2019-03-04T09:02:11Z | |
html.description.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. |