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Randomized Controlled Trial
. 2009 Jan 7:8:5.
doi: 10.1186/1475-2875-8-5.

Artemisinin-based combinations versus amodiaquine plus sulphadoxine-pyrimethamine for the treatment of uncomplicated malaria in Faladje, Mali

Kassoum Kayentao  1 , Hamma Maiga, Robert D Newman, Meredith L McMorrow, Annett Hoppe, Oumar Yattara, Hamidou Traore, Younoussou Kone, Etienne A Guirou, Renion Saye, Boubacar Traore, Abdoulaye Djimde, Ogobara K Doumbo
Affiliations
Randomized Controlled Trial

Artemisinin-based combinations versus amodiaquine plus sulphadoxine-pyrimethamine for the treatment of uncomplicated malaria in Faladje, Mali

Kassoum Kayentao et al. Malar J. .

Abstract

Background: Because of the emergence of chloroquine resistance in Mali, artemether-lumefantrine (AL) or artesunate-amodiaquine (AS+AQ) are recommended as first-line therapy for uncomplicated malaria, but have not been available in Mali until recently because of high costs.

Methods: From July 2005 to January 2006, a randomized open-label trial of three oral antimalarial combinations, namely AS+AQ, artesunate plus sulphadoxine-pyrimethamine (AS+SP), and amodiaquine plus sulphadoxine-pyrimethamine (AQ+SP), was conducted in Faladje, Mali. Parasite genotyping by polymerase chain reaction (PCR) was used to distinguish new from recrudescent Plasmodium falciparum infections.

Results: 397 children 6 to 59 months of age with uncomplicated Plasmodium falciparum malaria were enrolled, and followed for 28 days to assess treatment efficacy. Baseline characteristics were similar in all three treatment groups. The uncorrected rates of adequate clinical and parasitologic response (ACPR) were 55.7%, 90.8%, and 97.7% in AS+AQ, AS+SP, and AQ+SP respectively (p < 0.001); after PCR correction ACPR rates were similar among treatment groups: 95.4%, 96.9%, and 99.2% respectively (p = 0.17). Mean haemoglobin concentration increased across all treatment groups from Day 0 (9.82 +/- 1.68 g/dL) to Day 28 (10.78 +/- 1.49 g/dL) (p < 0.001), with the greatest improvement occurring in children treated with AQ+SP. On Day 2, the prevalence of parasitaemia was significantly greater among children treated with AQ+SP (50.8%) than in children treated with AS+AQ (10.5%) or AS+SP (10.8%) (p < 0.001). No significant difference in gametocyte carriage was found between groups during the follow-up period.

Conclusion: The combination of AQ+SP provides a potentially low cost alternative for treatment of uncomplicated P. falciparum infection in Mali and appears to have the added value of longer protective effect against new infection.

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Figures

Figure 1
Figure 1
Profile of children screened, enrolled, and completing study protocol.
Figure 2
Figure 2
Proportion of children with gametocytes from day 0 to day 28, in Faladje among children aged 6–59 months.
See this image and copyright information in PMC

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References

    1. Sangho H, Diawara A, Diallo M, Sow S, Sango HA, Sacko M, Doumbo O. Assessment of chloroquine resistance two years after stopping chemoprophylaxis in 0 to 9-year-old children living in a malaria-endemic village of Mali. Med Trop. 2004;64:506–510. - PubMed
    1. De Radigues X, Diallo KI, Diallo M, Ngwakum PA, Maiga H, Djimde A, Sacko M, Doumbo O, Guthmann JP. Efficacy of chloroquine and sulfadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in Koumantou, Mali. Trans R Soc Trop Med Hyg. 2006;100:1013–1018. doi: 10.1016/j.trstmh.2006.03.004. - DOI - PubMed
    1. World Health Organization and UNICEF . WHO/HTM/MAL/20051102. WHO, Geneva, Switzerland; 2005. World Malaria report 2005.
    1. Djimdé AA, Fofana B, Sagara I, Sidibe B, Toure S, Dembele D, Dama S, Ouologuem D, Dicko A, Doumbo OK. Efficacy, safety, and selection of molecular markers of drug resistance by two ACTs in Mali. Am J Trop Med Hyg. 2008;78:455–461. - PubMed
    1. Sagara I, Dicko A, Djimde A, Guindo O, Kone M, Tolo Y, Thera MA, Sogoba M, Fofana M, Ouattara A, Sissoko M, Jansen HF, Doumbo OK. A randomized trial of Artesunate-sulfamethoxypyrazine pyrimethamine versus artemether lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali. Am J Trop Med Hyg. 2006;75:630–636. - PubMed

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