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Efficacy of artesunate plus amodiaquine, artesunate plus sulfadoxine-pyrimethamine, and chloroquine plus sulfadoxine-pyrimethamine in patients with uncomplicated Plasmodium falciparum in the Comoros Union.
Acta Trop. 2007 Jun; 102(3):176-81.AT

Abstract

Health policy makers in Comoros Union have considered a policy change recommending combination treatment to control malaria. We evaluated the efficacy of three antimalarial drug combinations, taken orally, to enable the authorities to make an evidence-based choice. The study was carried out in patients of 2-70 years old in Moroni, Moheli and Anjouan in 2003. We enrolled 168 patients with uncomplicated malaria from 1097 outpatients screened at the health centres. One hundred and fifty-eight patients, of whom half were under five years old, (mean age=11.1+/-13.9 years), were followed up for 14 days. According to PCR adjusted outcome, the therapeutic efficacy of artesunate+amodiaquine (AS+AQ) (n=54) and artesunate+sulfadoxine-pyrimethamine (AS+SP) (n=53) was 100%, whereas that of chloroquine+sulfadoxine-pyrimethamine (CQ+SP) was 98% (50/51). The key difference between these treatments was the higher parasite clearance rate on Day 2 obtained with artesunate-containing combinations (P<0.001). These results provide a baseline for monitoring changes in the susceptibility of Plasmodium falciparum to artesunate+amodiaquine and artesunate+sulfadoxine-pyrimethamine (ACTs) in the Comoros Union. Health policy changes involving the replacement of chloroquine in the Indian Ocean subregion are discussed.

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Authors+Show Affiliations

Tall A
Unité de recherche sur le paludisme, Institut Pasteur de Madagascar, BP 1274 Antananarivo (101), Madagascar.
Rabarijaona LP
No affiliation info available
Robert V
No affiliation info available
Bedja SA
No affiliation info available
Ariey F
No affiliation info available
Randrianarivelojosia M
No affiliation info available

MeSH

AdolescentAdultAgedAmodiaquineAnimalsAntimalarialsArtemisininsArtesunateChildChild, PreschoolChloroquineComorosDrug CombinationsDrug Therapy, CombinationFemaleHumansMalaria, FalciparumMaleMiddle AgedPlasmodium falciparumPyrimethamineSesquiterpenesSulfadoxine

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17568549

Citation

Tall, Adama, et al. "Efficacy of Artesunate Plus Amodiaquine, Artesunate Plus Sulfadoxine-pyrimethamine, and Chloroquine Plus Sulfadoxine-pyrimethamine in Patients With Uncomplicated Plasmodium Falciparum in the Comoros Union." Acta Tropica, vol. 102, no. 3, 2007, pp. 176-81.
Tall A, Rabarijaona LP, Robert V, et al. Efficacy of artesunate plus amodiaquine, artesunate plus sulfadoxine-pyrimethamine, and chloroquine plus sulfadoxine-pyrimethamine in patients with uncomplicated Plasmodium falciparum in the Comoros Union. Acta Trop. 2007;102(3):176-81.
Tall, A., Rabarijaona, L. P., Robert, V., Bedja, S. A., Ariey, F., & Randrianarivelojosia, M. (2007). Efficacy of artesunate plus amodiaquine, artesunate plus sulfadoxine-pyrimethamine, and chloroquine plus sulfadoxine-pyrimethamine in patients with uncomplicated Plasmodium falciparum in the Comoros Union. Acta Tropica, 102(3), 176-81.
Tall A, et al. Efficacy of Artesunate Plus Amodiaquine, Artesunate Plus Sulfadoxine-pyrimethamine, and Chloroquine Plus Sulfadoxine-pyrimethamine in Patients With Uncomplicated Plasmodium Falciparum in the Comoros Union. Acta Trop. 2007;102(3):176-81. PubMed PMID: 17568549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of artesunate plus amodiaquine, artesunate plus sulfadoxine-pyrimethamine, and chloroquine plus sulfadoxine-pyrimethamine in patients with uncomplicated Plasmodium falciparum in the Comoros Union. AU - Tall,Adama, AU - Rabarijaona,Léon P, AU - Robert,Vincent, AU - Bedja,Said Ahmed, AU - Ariey,Frédéric, AU - Randrianarivelojosia,Milijaona, Y1 - 2007/05/03/ PY - 2007/03/25/received PY - 2007/03/25/accepted PY - 2007/6/15/pubmed PY - 2007/10/4/medline PY - 2007/6/15/entrez SP - 176 EP - 81 JF - Acta tropica JO - Acta Trop VL - 102 IS - 3 N2 - Health policy makers in Comoros Union have considered a policy change recommending combination treatment to control malaria. We evaluated the efficacy of three antimalarial drug combinations, taken orally, to enable the authorities to make an evidence-based choice. The study was carried out in patients of 2-70 years old in Moroni, Moheli and Anjouan in 2003. We enrolled 168 patients with uncomplicated malaria from 1097 outpatients screened at the health centres. One hundred and fifty-eight patients, of whom half were under five years old, (mean age=11.1+/-13.9 years), were followed up for 14 days. According to PCR adjusted outcome, the therapeutic efficacy of artesunate+amodiaquine (AS+AQ) (n=54) and artesunate+sulfadoxine-pyrimethamine (AS+SP) (n=53) was 100%, whereas that of chloroquine+sulfadoxine-pyrimethamine (CQ+SP) was 98% (50/51). The key difference between these treatments was the higher parasite clearance rate on Day 2 obtained with artesunate-containing combinations (P<0.001). These results provide a baseline for monitoring changes in the susceptibility of Plasmodium falciparum to artesunate+amodiaquine and artesunate+sulfadoxine-pyrimethamine (ACTs) in the Comoros Union. Health policy changes involving the replacement of chloroquine in the Indian Ocean subregion are discussed. SN - 0001-706X UR - https://www.unboundmedicine.com/medline/citation/17568549/Efficacy_of_artesunate_plus_amodiaquine_artesunate_plus_sulfadoxine_pyrimethamine_and_chloroquine_plus_sulfadoxine_pyrimethamine_in_patients_with_uncomplicated_Plasmodium_falciparum_in_the_Comoros_Union_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0001-706X(07)00118-0 DB - PRIME DP - Unbound Medicine ER -
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