Efficacy of artesunate plus pyrimethamine-sulphadoxine for uncomplicated malaria in Gambian children: a double-blind, randomised, controlled trial

Seidlein, Lorenz von; Milligan, Paul; Pinder, Margaret; Bojang, Kalifa; Anyalebechi, C; Gosling, Roly; Coleman, Rosalind; Ude, J I; Sadiq, Alisat; Duraisingh, Manoj T.; Warhurst, David C.; Alloueche, Ali; Targett, G. A. T.; McAdam, Keith P. W. J.; Greenwood, Brian; Walraven, Gijs; Olliaro, Piero; Doherty, T.

doi:10.1016/s0140-6736(99)10237-x

Cited by 174 publications

(125 citation statements)

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“…SP resistance remains low in Burkina Faso and in the neighbouring countries probably because its use is still extremely low. In 1999, SP resistance was lower than 1% in Mali (Diourté et al 1999) and 3.1% in The Gambia (Von Seidlein et al 2000). A longer follow-up, at least until day 28 after treatment, might have identified more late recrudescences.…”

Section: Discussionmentioning

confidence: 97%

Chloroquine and sulphadoxine‐pyrimethamine efficacy for uncomplicated malaria treatment and haematological recovery in children in Bobo‐Dioulasso, Burkina Faso during a 3‐year period 1998–2000

Tinto

Zoungrana

Coulibaly

et al. 2002

Tropical Med Int Health

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SummaryWe determined the parasitological resistance and the clinical failure to chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) by the WHO 14-day in vivo test over three consecutive years in 948 children aged 6-59 months with uncomplicated malaria attending four health centres in the province of Houet, Burkina Faso. Children were alternatively allocated to either CQ or SP. Packed cell volume (PCV) was measured at days 0 and 14. Parasitological resistance (RI, RII and RIII) to CQ was 18% (83 of 455) and to SP <1% (two of 308). Clinical failure with CQ was 12% (53 of 455) with no evidence of increase over time. Only one case of clinical failure was detected among the children treated with SP. The prevalence of anaemia (PCV <25%) was about 40% at day 0 and had decreased substantially by day 14 in both groups. However, in children treated with SP the prevalence of anaemia at day 14 was significantly lower than in those treated with CQ:RR ¼ 3.15 (95% CI: 1.33-7.42, P ¼ 0.008). CQ and SP are still efficacious for the treatment of uncomplicated malaria in children, at least in this area of Burkina Faso. However, the prevalences of CQ resistance reported from other areas of the country are worrying because of its potential spread. Regular surveillance of resistance to commonly used antimalarial drugs should continue.

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Section: Discussionmentioning

confidence: 97%

Chloroquine and sulphadoxine‐pyrimethamine efficacy for uncomplicated malaria treatment and haematological recovery in children in Bobo‐Dioulasso, Burkina Faso during a 3‐year period 1998–2000

Tinto

Zoungrana

Coulibaly

et al. 2002

Tropical Med Int Health

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“…against uncomplicated P. falciparum infection in African children under very controlled settings. 36 It is unclear how efficacious this combination would be in areas with high levels of SP monotherapy resistance. When patients in Thailand experienced high levels of MQ failures, combining MQ with artesunate reduced the failure rate from 31% to 2%.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of mefloquine and sulfadoxine-pyrimethamine for the treatment of uncomplicated Plasmodium falciparum infection in Machinga District, Malawi, 1998.

MacArthur

Stennies²,

Macheso³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. In response to the spread of chloroquine-resistant Plasmodium falciparum, Malaŵ i changed its first-line antimalarial drug in 1993 from chloroquine to sulfadoxine-pyrimethamine (SP). Surveillance data has suggested that resistance to SP may be increasing. We compared the efficacy of SP with a potential successor, mefloquine (MQ). By use of a modified World Health Organization in vivo protocol, children infected with P. falciparum were randomized to receive SP (sulfadoxine 25 mg/kg) or MQ (15 mg/kg). We observed combined RII and RIII parasitologic failures of 20.0 and 22.0% in the SP and MQ arms, respectively. Among those in the MQ arm, the relative hazard of failing with a Day 2 drug level Ͻ 500 ng/mL was 10.6 times higher than those with levels Ն 500 ng/mL. Given the decreased efficacy of the first-line antimalarial drug and the high failure rates of MQ at this lower dosage, Malaŵ i should consider assessing the efficacy and feasibility of alternative drugs to treat uncomplicated falciparum malaria.

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“…These combinations include artesunate with mefloquine, amodiaquine, SP, and atovaquone-proguanil, artemether with lumefantrine, and dihydroartemisinin with piperaquine. 7,73,[97][98][99][100] The safety of these combinations needs to be further assessed.…”

Section: Prospects For New Drugsmentioning

confidence: 99%

Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development

Guérin¹,

Olliaro

Nosten

et al. 2002

The Lancet Infectious Diseases

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Efficacy of artesunate plus pyrimethamine-sulphadoxine for uncomplicated malaria in Gambian children: a double-blind, randomised, controlled trial

Cited by 174 publications

References 17 publications

Chloroquine and sulphadoxine‐pyrimethamine efficacy for uncomplicated malaria treatment and haematological recovery in children in Bobo‐Dioulasso, Burkina Faso during a 3‐year period 1998–2000

Chloroquine and sulphadoxine‐pyrimethamine efficacy for uncomplicated malaria treatment and haematological recovery in children in Bobo‐Dioulasso, Burkina Faso during a 3‐year period 1998–2000

Efficacy of mefloquine and sulfadoxine-pyrimethamine for the treatment of uncomplicated Plasmodium falciparum infection in Machinga District, Malawi, 1998.

Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development

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