Artesunate – amodiaquine combination therapy for falciparum malaria in young Gabonese children

Abstract

BackgroundArtesunate-amodiaquine combination for the treatment of childhood malaria is one of the artemisinin combination therapies (ACTs) recommended by National authorities in many African countries today. Effectiveness data on this combination in young children is scarce.MethodsThe effectiveness of three daily doses of artesunate plus amodiaquine combination given unsupervised (n = 32), compared with the efficacy when given under full supervision (n = 29) to children with falciparum malaria were assessed in an unrandomized study.Results61 patients analysed revealed a PCR-corrected day-28 cure rate of 86 % (25 of 29 patients; CI 69 – 95 %) in the supervised group and 63 % (20 of 32 patients; CI 45 – 77 %) in the unsupervised group. The difference in outcome between both groups was statistically significant (p = 0.04). No severe adverse events were reported.ConclusionThe effectiveness of this short course regimen in young children with falciparum malaria could be augmented by increased adherence and improved formulation.

Artesunate-amodiaquine efficacy in Congolese children with acute uncomplicated falciparum malaria in Brazzaville

“…In the Democratic Republic of Congo, two studies conducted between 2003 and 2004 in Equator, South Kivu, and Katanga provinces reported paradoxical results with 85%, 93%, and 100% of ACPR, respectively [33,34]. In two studies conducted in Gabon, AS + AQ has shown an efficacy of 90% [29] and 86% [35]. The efficacy reported in the present study is comparable to that recently reported in other African countries, like Ghana [36,37].…”

Multicentre study evaluating the non-inferiority of the new paediatric formulation of artesunate/amodiaquine versus artemether/lumefantrine for the management of uncomplicated Plasmodium falciparum malaria in children in Cameroon, Ivory Coast and Senegal

“…However, it should be pointed out that this good efficacy is highly correlated with a supervised dose administration. In fact, several studies demonstrated a lower efficacy level in case of a non-supervised administration [21-23]. This drop in compliance when the association is used in daily practice (non-supervised dose) may in the long-term result in reduction of efficacy and could lead to the selection of resistant strains [21].…”

Placental Malaria Increases Malaria Risk in the First 30 Months of Life

“…Until mid-August 2004, malaria attacks were treated with artesunate monotherapy [22]; thereafter, they were treated with artesunate-amodiaquine [23].…”