Efficacy of chloroquine and sulfadoxine/pyrimethamine for the treatment of uncomplicated falciparum malaria in Koumantou, Mali.
Authors
de Radiguès, XDiallo, K I
Diallo, M
Ngwakum, P A
Maiga, H
Djimdé, A
Sacko, M
Doumbo, O
Guthmann, J P
Affiliation
Epicentre, 42 bis, Boulevard Richard Lenoir, 75011 Paris, France. xderadigues@epicentre.msf.orgIssue Date
2006-11
Metadata
Show full item recordAbstract
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.Publisher
ElsevierPubMed ID
16765395Additional Links
http://www.sciencedirect.com/science/journal/00359203Language
enISSN
0035-9203ae974a485f413a2113503eed53cd6c53
10.1016/j.trstmh.2006.03.004