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A comparison of the efficacy of artesunate plus sulfadoxine-pyrimethamine with that of sulfadoxine-pyrimethamine alone, in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan
In an open, randomized, clinical trial, conducted in New Halfa, eastern Sudan, in September-October 2004, the efficacies and adverse effects of artesunate plus sulfadoxine-pyrimethamine (SP), in the treatment of uncomplicated, Plasmodium falciparum malaria, were compared with those of SP alone. Pati...
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| Published in: | Annals of tropical medicine and parasitology 2005-07, Vol.99 (5), p.449-455 |
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| container_title | Annals of tropical medicine and parasitology |
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| creator | Adam, I. A-Elbasit, I. E. Idris, S. M. Malik, E. M. Elbashir, M. I. |
| description | In an open, randomized, clinical trial, conducted in New Halfa, eastern Sudan, in September-October 2004, the efficacies and adverse effects of artesunate plus sulfadoxine-pyrimethamine (SP), in the treatment of uncomplicated, Plasmodium falciparum malaria, were compared with those of SP alone. Patients were randomized to receive either artesunate (4 mg/kg. day) on days 0-2 plus SP (25 mg sulfadoxine/kg) on day 0 or the SP alone, and then followed-up for 28 days. Sixty patients completed follow-up. Compared with the 30 given artesunate plus SP (ASP), the 30 given SP alone were much more likely to be febrile (30% v. 3.3%; P=0.006) and parasitaemic (50% v. 6.7%; P |
| doi_str_mv | 10.1179/136485905X36299 |
| format | article |
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Adverse effects of treatment (nausea, itching and giddiness) were observed with similar frequencies in the two treatment arms (10.0% of the patients given ASP v. 13.3% of the patients given SP alone; P>0.05). The frequencies of gametocytaemia during follow-up were, however, much lower in the ASP arm than in the SP-only (0.0% v. 23.3%; P=0.005).
Thus, although the problems posed by adverse effects were similar in the two treatment arms, ASP appeared markedly better, in terms of fever- and parasite-clearance times and the prevalence of post-treatment gametocytaemia, than SP alone.</description><identifier>ISSN: 0003-4983</identifier><identifier>EISSN: 1364-8594</identifier><identifier>DOI: 10.1179/136485905X36299</identifier><identifier>PMID: 16004704</identifier><identifier>CODEN: ATMPA2</identifier><language>eng</language><publisher>Leeds: Taylor & Francis</publisher><subject>Adolescent ; Antimalarials - adverse effects ; Antimalarials - therapeutic use ; Artemisinins - adverse effects ; Artemisinins - therapeutic use ; Biological and medical sciences ; Child ; Child, Preschool ; Drug Combinations ; Drug Therapy, Combination ; Female ; General aspects ; Human protozoal diseases ; Humans ; Infectious diseases ; Malaria ; Malaria, Falciparum - drug therapy ; Male ; Medical sciences ; Parasitemia - drug therapy ; Parasitic diseases ; Plasmodium falciparum ; Protozoal diseases ; Pyrimethamine - adverse effects ; Pyrimethamine - therapeutic use ; Recurrence ; Sesquiterpenes - adverse effects ; Sesquiterpenes - therapeutic use ; Sudan ; Sulfadoxine - adverse effects ; Sulfadoxine - therapeutic use ; Treatment Failure ; Treatment Outcome</subject><ispartof>Annals of tropical medicine and parasitology, 2005-07, Vol.99 (5), p.449-455</ispartof><rights>2005 Maney Publishing 2005</rights><rights>2005 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-ecf02f74c6147211067aa07e0558b8bb45a217b4a3144181288e6a18203fddd83</citedby><cites>FETCH-LOGICAL-c407t-ecf02f74c6147211067aa07e0558b8bb45a217b4a3144181288e6a18203fddd83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16943916$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16004704$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adam, I.</creatorcontrib><creatorcontrib>A-Elbasit, I. E.</creatorcontrib><creatorcontrib>Idris, S. M.</creatorcontrib><creatorcontrib>Malik, E. M.</creatorcontrib><creatorcontrib>Elbashir, M. I.</creatorcontrib><title>A comparison of the efficacy of artesunate plus sulfadoxine-pyrimethamine with that of sulfadoxine-pyrimethamine alone, in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan</title><title>Annals of tropical medicine and parasitology</title><addtitle>Ann Trop Med Parasitol</addtitle><description>In an open, randomized, clinical trial, conducted in New Halfa, eastern Sudan, in September-October 2004, the efficacies and adverse effects of artesunate plus sulfadoxine-pyrimethamine (SP), in the treatment of uncomplicated, Plasmodium falciparum malaria, were compared with those of SP alone. Patients were randomized to receive either artesunate (4 mg/kg. day) on days 0-2 plus SP (25 mg sulfadoxine/kg) on day 0 or the SP alone, and then followed-up for 28 days. Sixty patients completed follow-up. Compared with the 30 given artesunate plus SP (ASP), the 30 given SP alone were much more likely to be febrile (30% v. 3.3%; P=0.006) and parasitaemic (50% v. 6.7%; P<00001) on day 1. By day 3, 16.7% of the patients given SP alone were still febrile and 6.7% of them were still parasitaemic, although all the patients given ASP were then afebrile (P=0.02) and aparasitaemic (P=0.1). Five (16.7%) of the patients treated with SP alone but none of those given ASP appeared to be treatment failures (P<0.05). Parasite genotyping revealed that four of the five apparent treatment failures were true recrudescences but the other represented a re-infection detected on day 28. The true frequencies of cure by day 28 were therefore 100% for ASP and 86.7% for SP alone (P=0.02).
Adverse effects of treatment (nausea, itching and giddiness) were observed with similar frequencies in the two treatment arms (10.0% of the patients given ASP v. 13.3% of the patients given SP alone; P>0.05). The frequencies of gametocytaemia during follow-up were, however, much lower in the ASP arm than in the SP-only (0.0% v. 23.3%; P=0.005).
Thus, although the problems posed by adverse effects were similar in the two treatment arms, ASP appeared markedly better, in terms of fever- and parasite-clearance times and the prevalence of post-treatment gametocytaemia, than SP alone.</description><subject>Adolescent</subject><subject>Antimalarials - adverse effects</subject><subject>Antimalarials - therapeutic use</subject><subject>Artemisinins - adverse effects</subject><subject>Artemisinins - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Drug Combinations</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>General aspects</subject><subject>Human protozoal diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Malaria</subject><subject>Malaria, Falciparum - drug therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Parasitemia - drug therapy</subject><subject>Parasitic diseases</subject><subject>Plasmodium falciparum</subject><subject>Protozoal diseases</subject><subject>Pyrimethamine - adverse effects</subject><subject>Pyrimethamine - therapeutic use</subject><subject>Recurrence</subject><subject>Sesquiterpenes - adverse effects</subject><subject>Sesquiterpenes - therapeutic use</subject><subject>Sudan</subject><subject>Sulfadoxine - adverse effects</subject><subject>Sulfadoxine - therapeutic use</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><issn>0003-4983</issn><issn>1364-8594</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNp1kV1rFTEQhoMo9rR67Z3kRq-6bbKb_fKuFK1CQUEF75bZ7IQTyceaZGnPT-y_MttzxFLoVTLD877zMkPIG87OOG_7c141oqt7Vv-qmrLvn5HN2ilySzwnG8ZYVYi-q47IcYy_c1k2TLwkR7xhTLRMbMjdBZXezhB09I56RdMWKSqlJcjdWkNIGBcHCelslkjjYhRM_lY7LOZd0BbTFmyu6I1O2yyHtMqexsB4h6dUu_tRKSAki-5etLg1i8mzE06n9JuBaP2kF0sVGKlzyvy1YHJaWA0QYsLg6PdlAveKvMhUxNeH94T8_PTxx-Xn4vrr1ZfLi-tCCtamAqVipWqFbLhoS85Z0wKwFlldd2M3jqKGkrejgIoLwTtedh02wLuSVWqapq46Ie_3vnPwfxaMabA6SjQGHPolDrxl2Zc1GTzfgzL4GAOqYc57gLAbOBvW6w2PrpcVbw_Wy2hx-s8fzpWBdwcAogSjAjip4wOuF1XP19Ef9px2ygcLNz6YaUiwMz78E1VPpfgL0tq5dg</recordid><startdate>20050701</startdate><enddate>20050701</enddate><creator>Adam, I.</creator><creator>A-Elbasit, I. E.</creator><creator>Idris, S. M.</creator><creator>Malik, E. M.</creator><creator>Elbashir, M. I.</creator><general>Taylor & Francis</general><general>Maney Publishing</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>M7N</scope></search><sort><creationdate>20050701</creationdate><title>A comparison of the efficacy of artesunate plus sulfadoxine-pyrimethamine with that of sulfadoxine-pyrimethamine alone, in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan</title><author>Adam, I. ; A-Elbasit, I. E. ; Idris, S. M. ; Malik, E. M. ; Elbashir, M. I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-ecf02f74c6147211067aa07e0558b8bb45a217b4a3144181288e6a18203fddd83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Antimalarials - adverse effects</topic><topic>Antimalarials - therapeutic use</topic><topic>Artemisinins - adverse effects</topic><topic>Artemisinins - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Drug Combinations</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>General aspects</topic><topic>Human protozoal diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Malaria</topic><topic>Malaria, Falciparum - drug therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Parasitemia - drug therapy</topic><topic>Parasitic diseases</topic><topic>Plasmodium falciparum</topic><topic>Protozoal diseases</topic><topic>Pyrimethamine - adverse effects</topic><topic>Pyrimethamine - therapeutic use</topic><topic>Recurrence</topic><topic>Sesquiterpenes - adverse effects</topic><topic>Sesquiterpenes - therapeutic use</topic><topic>Sudan</topic><topic>Sulfadoxine - adverse effects</topic><topic>Sulfadoxine - therapeutic use</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Adam, I.</creatorcontrib><creatorcontrib>A-Elbasit, I. E.</creatorcontrib><creatorcontrib>Idris, S. M.</creatorcontrib><creatorcontrib>Malik, E. M.</creatorcontrib><creatorcontrib>Elbashir, M. I.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><jtitle>Annals of tropical medicine and parasitology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adam, I.</au><au>A-Elbasit, I. E.</au><au>Idris, S. M.</au><au>Malik, E. M.</au><au>Elbashir, M. I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of the efficacy of artesunate plus sulfadoxine-pyrimethamine with that of sulfadoxine-pyrimethamine alone, in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan</atitle><jtitle>Annals of tropical medicine and parasitology</jtitle><addtitle>Ann Trop Med Parasitol</addtitle><date>2005-07-01</date><risdate>2005</risdate><volume>99</volume><issue>5</issue><spage>449</spage><epage>455</epage><pages>449-455</pages><issn>0003-4983</issn><eissn>1364-8594</eissn><coden>ATMPA2</coden><abstract>In an open, randomized, clinical trial, conducted in New Halfa, eastern Sudan, in September-October 2004, the efficacies and adverse effects of artesunate plus sulfadoxine-pyrimethamine (SP), in the treatment of uncomplicated, Plasmodium falciparum malaria, were compared with those of SP alone. Patients were randomized to receive either artesunate (4 mg/kg. day) on days 0-2 plus SP (25 mg sulfadoxine/kg) on day 0 or the SP alone, and then followed-up for 28 days. Sixty patients completed follow-up. Compared with the 30 given artesunate plus SP (ASP), the 30 given SP alone were much more likely to be febrile (30% v. 3.3%; P=0.006) and parasitaemic (50% v. 6.7%; P<00001) on day 1. By day 3, 16.7% of the patients given SP alone were still febrile and 6.7% of them were still parasitaemic, although all the patients given ASP were then afebrile (P=0.02) and aparasitaemic (P=0.1). Five (16.7%) of the patients treated with SP alone but none of those given ASP appeared to be treatment failures (P<0.05). Parasite genotyping revealed that four of the five apparent treatment failures were true recrudescences but the other represented a re-infection detected on day 28. The true frequencies of cure by day 28 were therefore 100% for ASP and 86.7% for SP alone (P=0.02).
Adverse effects of treatment (nausea, itching and giddiness) were observed with similar frequencies in the two treatment arms (10.0% of the patients given ASP v. 13.3% of the patients given SP alone; P>0.05). The frequencies of gametocytaemia during follow-up were, however, much lower in the ASP arm than in the SP-only (0.0% v. 23.3%; P=0.005).
Thus, although the problems posed by adverse effects were similar in the two treatment arms, ASP appeared markedly better, in terms of fever- and parasite-clearance times and the prevalence of post-treatment gametocytaemia, than SP alone.</abstract><cop>Leeds</cop><pub>Taylor & Francis</pub><pmid>16004704</pmid><doi>10.1179/136485905X36299</doi><tpages>7</tpages></addata></record> |
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| ispartof | Annals of tropical medicine and parasitology, 2005-07, Vol.99 (5), p.449-455 |
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| subjects | Adolescent Antimalarials - adverse effects Antimalarials - therapeutic use Artemisinins - adverse effects Artemisinins - therapeutic use Biological and medical sciences Child Child, Preschool Drug Combinations Drug Therapy, Combination Female General aspects Human protozoal diseases Humans Infectious diseases Malaria Malaria, Falciparum - drug therapy Male Medical sciences Parasitemia - drug therapy Parasitic diseases Plasmodium falciparum Protozoal diseases Pyrimethamine - adverse effects Pyrimethamine - therapeutic use Recurrence Sesquiterpenes - adverse effects Sesquiterpenes - therapeutic use Sudan Sulfadoxine - adverse effects Sulfadoxine - therapeutic use Treatment Failure Treatment Outcome |
| title | A comparison of the efficacy of artesunate plus sulfadoxine-pyrimethamine with that of sulfadoxine-pyrimethamine alone, in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan |
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