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    Mar 04, 2021
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    Efficacy of chloroquine + sulfadoxine--pyrimethamine, mefloquine + artesunate and artemether + lumefantrine combination therapies to treat Plasmodium falciparum malaria in the Chittagong Hill Tracts, Bangladesh.

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    Authors
    van den Broek, I
    Maung, U A
    Peters, A
    Liem, L
    Kamal, M
    Rahman, M
    Rahman, M
    Bangali, A M
    Das, S
    Barends, M
    Faiz, A M
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    Affiliation
    MSF-UK, London, UK. ingrid.van.den.broek@london.msf.org
    Issue Date
    2005-10
    
    Metadata
    Show full item record
    Journal
    Transactions of the Royal Society of Tropical Medicine and Hygiene
    Abstract
    Bangladesh faces growing levels of Plasmodium falciparum resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP). Alternative antimalarial therapies, particularly combination regimens, need to be considered. Therefore, the efficacy of three antimalarial combination therapies was assessed in Chittagong Hill Tracts. A total of 364 P. falciparum patients were recruited and randomly assigned to either CQ + SP, mefloquine + artesunate (MQ + AS) or lumefantrine + artemether (Coartem). Results showed that CQ + SP therapy was less effective than the two artemisinin-based combination therapies. The day 42 PCR-corrected efficacy rate was 62.4% for CQ + SP, 100% for MQ + AS and 97.1% for Coartem. Failures occurred at a shorter interval after CQ + SP treatment than after Coartem. The artemisinin-based therapies effectively prevented development of gametocytes, whereas CQ + SP did not. All three therapies were well tolerated, although reports of mild complaints during treatment appeared higher with MQ + AS. We conclude that CQ + SP is not a viable option for replacing CQ monotherapy as first-line P. falciparum treatment in this area of Bangladesh. A change to artemisinin-based combination therapy is recommended. Both Coartem and MQ + AS appear to be good options, effective in curing P. falciparum malaria and in preventing recrudescences following treatment.
    Publisher
    Elsevier
    URI
    http://hdl.handle.net/10144/17274
    DOI
    10.1016/j.trstmh.2005.02.007
    PubMed ID
    16095643
    Additional Links
    http://www.sciencedirect.com/science/journal/00359203
    Language
    en
    ISSN
    0035-9203
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.trstmh.2005.02.007
    Scopus Count
    Collections
    Malaria

    entitlement

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