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
Randomized Controlled Trial
. 2007 Dec 21:6:170.
doi: 10.1186/1475-2875-6-170.

Adding artesunate to sulphadoxine-pyrimethamine greatly improves the treatment efficacy in children with uncomplicated falciparum malaria on the coast of Benin, West Africa

Alain Nahum  1 , Annette Erhart, Dorothée Gazard, Carine Agbowai, Chantal Van Overmeir, Harry van Loen, Joris Menten, Martin Akogbeto, Marc Coosemans, Achille Massougbodji, Umberto D'Alessandro
Affiliations
Randomized Controlled Trial

Adding artesunate to sulphadoxine-pyrimethamine greatly improves the treatment efficacy in children with uncomplicated falciparum malaria on the coast of Benin, West Africa

Alain Nahum et al. Malar J. .

Abstract

Background: Benin has recently shifted its national antimalarial drug policy from monotherapies to combinations containing artemisinin derivatives. When this decision was taken, the available information on alternatives to chloroquine and sulphadoxine-pyrimethamine, the first- and second-line treatment, was sparse.

Methods: In 2003 - 2005, before the drug policy change, a randomized, open-label, clinical trial was carried out on the efficacy of chloroquine, and sulphadoxine-pyrimethamine alone or combined with artesunate, with the aim of providing policy makers with the information needed to formulate a new antimalarial drug policy. Children between six and 59 months of age, with uncomplicated malaria and living in the lagoon costal area in southern Benin, were randomly allocated to one of the three study arms and followed up for 28 days.

Results: Treatment failure (PCR corrected) was significantly lower in the artesunate + sulphadoxine-pyrimethamine group (4/77, 5.3%) than in chloroquine group(51/71, 71.8%) or the sulphadoxine-pyrimethamine alone group (30/70, 44.1%) (p < 0.001). Despite high sulphadoxine-pyrimethamine failure, its combination with artesunate greatly improved treatment efficacy.

Conclusion: In Benin, artesunate + sulphadoxine-pyrimethamine is efficacious and could be used when the recommended artemisinin-based combinations (artemether-lumefantrine and amodiaquine-artesunate) are not available. However, because sulphadoxine-pyrimethamine is also used in pregnant women as intermittent preventive treatment, its combination with artesunate should not be widely employed in malaria patients as this may compromise the efficacy of intermittent preventive treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Trial profile. ◦ CQ = Chloroquine; *SP = Sulfadoxine-Pyrimethamine; ◦◦ AS = Artesunate.
Figure 2
Figure 2
Kaplan Meier survival curves (PCR Adjusted) by treatment group.
See this image and copyright information in PMC

References

    1. Programme National de Lutte contre le Paludisme Politique nationale de lutte contre le paludisme et cadre stratégique de mise en æuvre Cotonou. 2005.
    1. Programme National de Lutte contre le Paludisme Atelier de consensus sur le changement de la politique de traitement antipaludique Cotonou. 2004.
    1. Programme National de Lutte contre le Paludisme Reprise du dépouillement des fiches de suivi et individuelles des enfants retenus pour le test de chimiosensibilité réalisé en 2002 au Bénin Cotonou. 2003.
    1. Le Bras J, Hatin I, Bourée P, Coco-Cianci O, Garin J-P, Rey M, Charmot G, Roue R. Chloroquine-resistant falciparum malaria in Benin. Lancet. 1986;2:1043–1044. doi: 10.1016/S0140-6736(86)92657-7. - DOI - PubMed
    1. Rosenheim M, Prazuck T, Brandicourt O, Diquet B, Datry A, Danis M, Gentilini M. Five cases of chloroquine-resistant malaria in Benin, Africa. Trans R Soc Trop Med Hyg. 1987;81:498. doi: 10.1016/0035-9203(87)90174-X. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources