Chloroquine or amodiaquine combined with sulfadoxine-pyrimethamine for treating uncomplicated malaria

McIntosh, HM

doi:10.1002/14651858.cd000386

Cited by 15 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a systematic review, combinations of SP with either CQ or amodiaquine (AQ) provided improved fever clearance but similar treatment outcomes to SP monotherapy. 8 However, resistance to SP was very low in these five studies. With increasing levels of SP resistance, SPaminoquinoline combinations may offer more-significant advantages in therapeutic efficacy.…”

Section: Introductionmentioning

confidence: 83%

“…The combination of SP/CQ was chosen as the provisional replacement for first-line therapy of uncomplicated malaria. Limited information is available regarding the efficacy of SP/CQ, 8,10,11 but no trials with this combination have been conducted in Uganda. Recent studies of SP/AQ in Kampala indicated that the combination regimen was safe and highly efficacious for the treatment of uncomplicated malaria.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparative Efficacy of Aminoquinoline-Antifolate Combinations for the Treatment of Uncomplicated Falciparum Malaria in Kampala, Uganda

Gasasira¹,

Dorsey²,

Nzarubara³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Resistance to chloroquine (CQ) requires its replacement as first-line therapy for uncomplicated malaria in much of Africa. Combination therapy may improve efficacy and delay the selection of resistant malaria parasites. Combinations of sulfadoxine-pyrimethamine (SP) with 4-aminoquinolines offer affordable and available alternatives to CQ. We conducted a randomized, single-blinded trial to compare the efficacy of SP monotherapy with combinations of SP and either CQ or amodiaquine (AQ) for the treatment of uncomplicated falciparum malaria in patients over 6 months of age in Kampala, Uganda. Of the 448 patients enrolled, 428 (95%) completed follow-up. Clinical treatment failure after 14 days occurred in 21/140 (15.0%, 95% CI 9.5-22.0%) SP-treated, 11/152 (7.2%, 95% CI 3.7-12.6%) SP/CQ-treated, and 0/136 (0%, 95% CI 0-2.7%) SP/AQ-treated patients. Combination therapies were safe and offered superior efficacy to SP monotherapy. SP/AQ was the most efficacious. This low-cost combination regimen may provide an optimal alternative to CQ for the treatment of uncomplicated malaria in Uganda.

show abstract

Section: Introductionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Aminoquinoline-Antifolate Combinations for the Treatment of Uncomplicated Falciparum Malaria in Kampala, Uganda

Gasasira¹,

Dorsey²,

Nzarubara³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…While full details of the included systematic reviews are available elsewhere, (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) a brief description of the topic of each review is provided in the second column of Table 1.…”

Section: Results: Of the 67 Reviews In The Cochrane Collaboration Infmentioning

confidence: 99%

“…Firstly, the review ranked second for updating by Barowman:n ratio and power and ranked fourth based on the weight ratioChloroquine or amodiaquine combined with sulfadoxine-pyrimethamine for treating uncomplicated malaria (21). The primary outcome in the meta-analysis is failure by day 28.…”

Section: Results: Of the 67 Reviews In The Cochrane Collaboration Infmentioning

confidence: 99%

An encouraging assessment of methods to inform priorities for updating systematic reviews

Sutton¹,

Donegan²,

Takwoingi³

et al. 2009

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

Objectives:To consider the use of statistical methods that aim to prioritise the updating of a collection of systematic reviews based on preliminary literature searches. Methods:A new simulation based method estimating statistical power and the ratio of the weights assigned to the predicted new and old evidence and the existing Barrowman n approach are considered. Using only information on the numbers of subjects randomised in the "new" trials, these were applied retrospectively, by removing recent studies, to existing systematic reviews from the Cochrane Infectious Diseases Group. Results:Twelve systematic reviews were included. When the removed studies were reinstated, inferences changed in five of them. These reviews were ranked, in order of update priority, 1, 2, 3 , 4 and 11 and 1, 2, 3, 4 and 12 by the Barrowman n and simulation based power approaches respectively. The low ranking of one significant meta-analysis by both methods was due to unexpectedly favourable results in the reinstated study. Conclusions:This study demonstrates the feasibility of the use of analytical methods to inform update prioritisation strategies. Under conditions of homogeneity, Barrowman"s n and simulated power were in close agreement. We encourage further, prospective, evaluation of these methods.Keywords: meta-analysis, systematic review, updating, power, methodology,

show abstract

“…Cuando se evaluó la combinación SDXP/CQ, se encontró que el mayor porcentaje de fallas en ambos municipios fue de tipo tardío, esto coincide con lo reportado en la literatura, donde se ha encontrado que la combinación SDXP/CQ es más efectiva comparada con CQ sola y el control de los síntomas (desaparición de la fiebre y mejoría referida por el paciente) es mayor si se utiliza la combinación comparado con SDXP como monoterapia (28). Esto puede deberse a la suma de la rápida acción esquizonticida de ambos medicamentos y al efecto antipirético y antiinflamatorio de la CQ (29).…”

Section: Discussionunclassified

Eficacia terapéutica de tres esquemas de tratamiento de malaria no complicada por Plasmodium falciparum, Antioquia, Colombia, 2002.

et al. 2003

View full text Add to dashboard Cite

La resistencia a medicamentos antimaláricos aumenta la carga de malaria en un país. En Colombia, la situación de los antimaláricos es apremiante dada la alta resistencia de Plasmodium falciparum a la cloroquina y la escasez mundial de amodiaquina. Ante este panorama, se evaluó la respuesta terapéutica a sulfadoxina/pirimetamina (SDXP) y cloroquina (CQ) como monoterapias y en combinación para el tratamiento de malaria no complicada por P. falciparum, aplicando el protocolo de OMS/OPS 1998, en Turbo y Zaragoza, dos municipios de Antioquia, Colombia. Se diseñó una muestra para grupos balanceados y los pacientes fueron asignados aleatoriamente a los grupos de tratamiento. Se evaluaron 160 pacientes con malaria por P. falciparum sin complicaciones. La distribución de pacientes de ambos municipios en cada grupo de tratamiento fue estadísticamente similar en la mayoría de variables. En Turbo hubo un porcentaje de falla terapéutica de 87,5% a CQ, 22,2% a SDXP y de 22,6% a la combinación, mientras en Zaragoza la falla terapéutica fue de 77% a CQ, 26,5% a SDXP y 12,1% a SDXP/CQ. Durante el seguimiento, 50% y 33,3% de los pacientes con falla terapéutica tardía en Turbo y Zaragoza, respectivamente, fueron asintomáticos. Este estudio encontró un alto nivel de falla terapéutica con CQ en ambos municipios, mientras la SDXP y la combinación mostraron niveles de falla cercanos al 25%. Es de anotar el hallazgo de pacientes con falla tardía parasitológica y el riesgo que significa esta situación en la permanencia de la transmisión.Palabras clave: cloroquina, sulfadoxina/pirimetamina, malaria, Plasmodium falciparum, falla terapéutica. Therapeutic efficacy of three treatment schemes in uncomplicated Plasmodium falciparum malaria in Antioquia, Colombia, 2002High resistance of Plasmodium falciparum malaria to chloroquine poses malaria as a major public health problem in Colombia. In this context, the therapeutic response of uncomplicated P. falciparum malaria patients to chloroquine (CQ), sulfadoxine/pirymethamine (SDXP) and combined therapy (SDXP/CQ) was evaluated according to the WHO/PAHO protocols of 1998. The comparisons were based on a sample of 160 patients with uncomplicated P. falciparum malaria in Turbo and Zaragoza (Antioquia, Colombia). Patients were randomly assigned each of the treatment categories. The results were statistically similar in each municipality. In Turbo percentage of treatment failure was 87.5%, 22.2% and 22.6% for CQ, SDXP and SDXP/CQ, respectively, whereas in Zaragoza, the corresponding treatment failure was 77.7%, 26.5% and 12.1%. During follow up, 50% of subjects with late treatment failure were asymptomatic in Turbo, while 33.3% were asymptomatic in Zaragoza. A high level of treatment failure occurred with CQ monotherapy, while SDXP and SDXP/CQ had acceptable levels of failure, i.e., below 25%. The high percentage of late treatment failure in asymptomatic patients may contribute to increased risk of persistent transmission.

show abstract

Chloroquine or amodiaquine combined with sulfadoxine-pyrimethamine for treating uncomplicated malaria

Cited by 15 publications

References 29 publications

Comparative Efficacy of Aminoquinoline-Antifolate Combinations for the Treatment of Uncomplicated Falciparum Malaria in Kampala, Uganda

Comparative Efficacy of Aminoquinoline-Antifolate Combinations for the Treatment of Uncomplicated Falciparum Malaria in Kampala, Uganda

An encouraging assessment of methods to inform priorities for updating systematic reviews

Eficacia terapéutica de tres esquemas de tratamiento de malaria no complicada por Plasmodium falciparum, Antioquia, Colombia, 2002.

Contact Info

Product

Resources

About