Clinical Trial

. 2015 Feb 7:14:64.

doi: 10.1186/s12936-015-0557-y.

Efficacy of sulphadoxine-pyrimethamine + artesunate, sulphadoxine-pyrimethamine + amodiaquine, and sulphadoxine-pyrimethamine alone in uncomplicated falciparum malaria in Mali

Hamma Maiga¹, Abdoulaye A Djimde², Abdoul H Beavogui³, Ousmane Toure⁴, Mamadou Tekete⁵, Cheick Papa O Sangare⁶, Antoine Dara⁷, Zoumana I Traore⁸, Oumar B Traore⁹, Souleymane Dama¹⁰, Christelle N'Dong¹¹, Hamidou Niangaly¹², Nouhoum Diallo¹³, Demba Dembele¹⁴, Issaka Sagara¹⁵, Ogobara K Doumbo¹⁶

Affiliations

¹ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. hmaiga@icermali.org.
² Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. adjimde@icermali.org.
³ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. beavoguia_h@yahoo.com.
⁴ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. obtoure@icermali.org.
⁵ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. mtekete@icermali.org.
⁶ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. oumar@icermali.org.
⁷ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. tonydara@icermali.org.
⁸ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. zouisaac@gmail.com.
⁹ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. bila@icermali.org.
¹⁰ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. dama@icermali.org.
¹¹ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. chris_ndong@hotmail.com.
¹² Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. hniangaly@icermali.org.
¹³ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. nouhoumd@icermali.org.
¹⁴ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. ddembele@icermali.org.
¹⁵ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. isagara@icermali.org.
¹⁶ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. okd@icermali.org.

PMID: 25889633
PMCID: PMC4326408
DOI: 10.1186/s12936-015-0557-y

Clinical Trial

Efficacy of sulphadoxine-pyrimethamine + artesunate, sulphadoxine-pyrimethamine + amodiaquine, and sulphadoxine-pyrimethamine alone in uncomplicated falciparum malaria in Mali

Hamma Maiga et al. Malar J. 2015.

. 2015 Feb 7:14:64.

doi: 10.1186/s12936-015-0557-y.

Authors

Affiliations

¹ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. hmaiga@icermali.org.
² Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. adjimde@icermali.org.
³ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. beavoguia_h@yahoo.com.
⁴ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. obtoure@icermali.org.
⁵ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. mtekete@icermali.org.
⁶ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. oumar@icermali.org.
⁷ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. tonydara@icermali.org.
⁸ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. zouisaac@gmail.com.
⁹ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. bila@icermali.org.
¹⁰ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. dama@icermali.org.
¹¹ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. chris_ndong@hotmail.com.
¹² Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. hniangaly@icermali.org.
¹³ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. nouhoumd@icermali.org.
¹⁴ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. ddembele@icermali.org.
¹⁵ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. isagara@icermali.org.
¹⁶ Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. okd@icermali.org.

PMID: 25889633
PMCID: PMC4326408
DOI: 10.1186/s12936-015-0557-y

Abstract

Background: Plasmodium falciparum resistance to artemisinin has been reported in South-East Asia. Long half-life drugs are increasingly being used for malaria prevention. The potential spread of parasite resistance to these regimens is real and makes regular efficacy surveillance a priority.

Methods: From August to December 2004 and July to December 2005, a randomized open label trial of sulphadoxine-pyrimethamine (SP) + artesunate (AS) versus SP + amodiaquine (AQ), and SP alone, was conducted in two villages of Mali. PCR was used to distinguish new infections from recrudescent P. falciparum infections. Patients were followed for 28 days to assess treatment efficacy.

Results: Overall 912 children aged between six to 59 months, with uncomplicated P. falciparum malaria were recruited. Baseline characteristics were similar in the three treatment arms. Crude ACPRs were 94.9%; 98.6% and 93.5% for SP + AS; SP + AQ and SP alone arms respectively (SP + AS versus SP + AQ, p = 0.01; SP + AS versus SP, p = 0.5; SP + AQ versus SP, p = 0.001). After PCR adjustment, cACPRs were 99%; 100% and 97.2% for SP + AS; SP + AQ and SP alone arms, respectively (SP + AS versus SP + AQ, p = 0.25; SP + AS versus SP, p = 0.12; SP + AQ versus SP, p = 0.007).

Conclusion: Sulphadoxine-pyrimethamine + amodiaquine therapy was as efficacious as sulphadoxine-pyrimethamine + artesunate, but more efficacious than sulphadoxine-pyrimethamine alone in the treatment of uncomplicated P. falciparum malaria in Mali.

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Figures

**Figure 2**
**Proportion of patients with fever (a), parasitaemia (b), gametocytes (c) and anaemia (d) at baseline to follow-up visit.**

See this image and copyright information in PMC

References

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Efficacy of sulphadoxine-pyrimethamine + artesunate, sulphadoxine-pyrimethamine + amodiaquine, and sulphadoxine-pyrimethamine alone in uncomplicated falciparum malaria in Mali

Affiliations

Efficacy of sulphadoxine-pyrimethamine + artesunate, sulphadoxine-pyrimethamine + amodiaquine, and sulphadoxine-pyrimethamine alone in uncomplicated falciparum malaria in Mali

Authors

Affiliations

Abstract

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LinkOut - more resources

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Research Materials