Document Detail


Therapeutic efficacy of sulfadoxine-pyrimethamine, amodiaquine and the sulfadoxine-pyrimethamine-amodiaquine combination against uncomplicated Plasmodium falciparum malaria in young children in Cameroon.
MedLine Citation:
PMID:  12163917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the therapeutic efficacy of sulfadoxine-pyrimethamine, amodiaquine, and the sulfadoxine-pyrimethamine-amodiaquine combination for the treatment of uncomplicated Plasmodium falciparum malaria in young children in Cameroon. METHODS: In a randomized study we evaluated the effectiveness and tolerance of (i) sulfadoxine-pyrimethamine (SP) (25 mg/kg body weight of sulfadoxine and 1.25 mg/kg of pyrimethamine in a single oral dose), (ii) amodiaquine (AQ) (30 mg/kg body weight in three divided daily doses), and (iii) the sulfadoxine-pyrimethamine-amodiaquine combination (SP+AQ) (same doses as in the other two treatment groups, given simultaneously on day 0) in young children in southern Cameroon. The parasitological and clinical responses were studied until day 28 in accordance with the modified 1996 WHO protocol for the evaluation of the therapeutic efficacy of antimalarial drugs. FINDINGS: Of 191 enrolled patients, 6 and 8 were excluded or lost to follow-up before day 14 and between day 14 and day 28, respectively. For the AQ-treated patients, parasitological and clinical evaluation on day 14 showed late treatment failure in 2 of 61 (3.3%) and adequate clinical response with parasitological failure in one (1.6%). There was an adequate clinical response in all patients treated with SP or SP+AQ. Therapeutic failure rates on day 28 were 13.6%, 10.2% and 0% in the SP, AQ, and SP+AQ groups, respectively. Anaemia improved in all three regimens. AQ produced faster fever clearance but was associated with more transient minor side-effects than SP. SP+AQ reduced the risk of recrudescence between day 14 and day 28 but increased the incidence of minor side-effects. CONCLUSION: SP+AQ can be recommended as a temporary means of slowing the spread of multidrug resistance in Plasmodium falciparum in Africa while the introduction of other combinations, including artemisinin derivatives, is awaited.
Authors:
Leonardo K Basco; Albert Same-Ekobo; Vincent Foumane Ngane; Mathieu Ndounga; Theresia Metoh; Pascal Ringwald; Georges Soula
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Bulletin of the World Health Organization     Volume:  80     ISSN:  0042-9686     ISO Abbreviation:  Bull. World Health Organ.     Publication Date:  2002  
Date Detail:
Created Date:  2002-08-06     Completed Date:  2003-08-12     Revised Date:  2009-05-29    
Medline Journal Info:
Nlm Unique ID:  7507052     Medline TA:  Bull World Health Organ     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  538-45     Citation Subset:  IM    
Affiliation:
Unité de Recherche Paludologie Afro-tropicale, Institut de Recherche pour le Développement, Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la Lutte contre les Endémies en Afrique Centrale, Yaoundé, Cameroon.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Amodiaquine / therapeutic use*
Antimalarials / therapeutic use*
Cameroon / epidemiology
Child
Child, Preschool
Drug Administration Schedule
Drug Combinations
Drug Monitoring
Drug Resistance
Drug Therapy, Combination
Female
Follow-Up Studies
Hematocrit
Humans
Malaria, Falciparum / blood,  drug therapy*,  epidemiology,  parasitology
Male
Parasitic Sensitivity Tests
Pyrimethamine / therapeutic use*
Sulfadoxine / therapeutic use*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Drug Combinations; 2447-57-6/Sulfadoxine; 37338-39-9/sulfadoxine-pyrimethamine; 58-14-0/Pyrimethamine; 86-42-0/Amodiaquine

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


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