Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Controlled Clinical Trial
. 2005 Feb 24:4:14.
doi: 10.1186/1475-2875-4-14.

Efficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan

Ingrid van den Broek  1 , Ribka Amsalu, Manica Balasegaram, Pamela Hepple, Engudaye Alemu, El Badri Hussein, Muhammed Al-Faith, Jacqui Montgomery, Francesco Checchi
Affiliations
Controlled Clinical Trial

Efficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan

Ingrid van den Broek et al. Malar J. .

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient flow during recruitment and follow-up
Figure 2
Figure 2
Parasitaemia and gametocytaemia during 6-week follow-up. Symbols: AS+SP ▲ parasites △ gametocytes, AS+AQ ● parasites ○ gametocytes. Error bars indicate 95%CI.
See this image and copyright information in PMC

References

    1. RBM RBM in Sudan progress report, 2002: Achievements, constraints and challenges. Republic of the Sudan Federal Ministry of Health National Malaria Control Programme. 2003. http://www.emro.who.int/rbm/SUDProgReport02.pdf
    1. NMA/UNICEF Report on Sentinel sites. Khartoum National Malaria Administration. 1999.
    1. Guthmann JP, Cetre C, Suzan F. Field research, relief work and war: does chloroquine-resistance occur in displaced populations of southern Sudan? Trop Doct. 1996;26:89–90. - PubMed
    1. van den Broek I, Gatkoi T, Lowoko B. Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan. Trans R Soc Trop Med Hyg. 2003;97:229–235. doi: 10.1016/S0035-9203(03)90128-3. - DOI - PubMed
    1. Bachy C, Checchi F, Cavalier P. Chloroquine and sulfadoxine-pyrimethamine drug sensitivity study for the treatment of uncomplicated malaria due to Plasmodium falciparum. Report Epicentre/MSF-Belgium, Mapel, Sudan. 2003.

Publication types

MeSH terms