Document Detail


Randomized comparison of chloroquine plus sulfadoxine-pyrimethamine versus artesunate plus mefloquine versus artemether-lumefantrine in the treatment of uncomplicated falciparum malaria in the Lao People's Democratic Republic.
MedLine Citation:
PMID:  15486837     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent clinical trials in the Lao People's Democratic Republic have demonstrated that chloroquine and sulfadoxine-pyrimethamine, which are national malaria treatment policy, are no longer effective in the treatment of uncomplicated Plasmodium falciparum malaria. METHODS: A randomized comparison of 3 oral antimalarial combinations--chloroquine plus sulfadoxine-pyrimethamine versus artesunate plus mefloquine versus artemether-lumefantrine--with 42-day follow-up period, was conducted among 330 patients with acute uncomplicated falciparum malaria in southern Laos. RESULTS: The 42-day cure rates, as determined by intention-to-treat analysis and adjusted for reinfection, were 100%, 97%, and 93% for the groups receiving artesunate plus mefloquine, artemether-lumefantrine, and chloroquine plus sulfadoxine-pyrimethamine, respectively. Of 8 patients receiving chloroquine plus sulfadoxine-pyrimethamine who experienced treatment failure, 6 had early treatment failure. The mean parasite clearance time was significantly longer in patients treated with chloroquine plus sulfadoxine-pyrimethamine (2.9 days; 95% confidence interval [CI], 2.8-3.0 days) than in those treated with artesunate plus mefloquine (2.07 days; 95% CI, 2.0-2.1 days; P<.001) and artemether-lumefantrine (2.08 days; 95% CI, 2.0-2.1 days; P<.001). Cure rates with artemether-lumefantrine were high despite low mean daily dietary fat intake (13.8 g; 95% CI, 12.5-15.1 g) and day 7 plasma lumefantrine concentrations (0.47 mu g/mL; 95% CI, 0.38-0.56 mu g/mL). CONCLUSION: Oral artesunate plus mefloquine and artemether-lumefantrine are highly effective for the treatment of uncomplicated falciparum malaria in Laos.
Authors:
Mayfong Mayxay; Maniphone Khanthavong; Niklas Lindegårdh; Siamphay Keola; Marion Barends; Tiengkham Pongvongsa; Ratsuda Yapom; Anna Annerberg; Samlane Phompida; Rattanaxay Phetsouvanh; Nicholas J White; Paul N Newton
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2004-09-27
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  39     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-15     Completed Date:  2006-06-01     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1139-47     Citation Subset:  IM    
Affiliation:
Wellcome Trust-Mahosot Hospital, Oxford Tropical Medicine Research Collaboration, Vientiane, Lao PDR.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antimalarials / therapeutic use*
Artemisinins / administration & dosage,  therapeutic use*
Child
Child, Preschool
Chloroquine / administration & dosage,  therapeutic use*
Drug Combinations
Drug Therapy, Combination
Ethanolamines / therapeutic use
Female
Fluorenes / therapeutic use
Humans
Infant
Laos
Malaria, Falciparum / drug therapy*
Male
Mefloquine / administration & dosage,  therapeutic use*
Pyrimethamine / administration & dosage,  therapeutic use*
Sesquiterpenes / administration & dosage,  therapeutic use*
Sulfadoxine / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Artemisinins; 0/Drug Combinations; 0/Ethanolamines; 0/Fluorenes; 0/Sesquiterpenes; 0/artemether; 2447-57-6/Sulfadoxine; 37338-39-9/sulfadoxine-pyrimethamine; 53230-10-7/Mefloquine; 54-05-7/Chloroquine; 58-14-0/Pyrimethamine; 82186-77-4/lumefantrine; 83507-69-1/artesunate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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