Efficacy of chloroquine, sulphadoxine–pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in Kajo Keji county, Sudan

Summary To provide advice on the rational use of antimalarial drugs, Médecins Sans Frontières conducted a randomized, an open label efficacy study in Kajo Keji, an area of high transmission of malaria in southern Sudan. The efficacy of chloroquine (CQ), sulphadoxine–pyrimethamine (SP) and amodiaquin...

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Bibliographic Details
Published in:Tropical medicine & international health 2004-09, Vol.9 (9), p.975-980
Main Authors: Stivanello, Elisa, Cavailler, Philippe, Cassano, Francesco, Omar, Sabah Ahmed, Kariuki, Daniel, Mwangi, Jonathan, Piola, Patrice, Guthmann, Jean‐Paul
Format: Article
Language:English
Subjects:
amodiaquine
Amodiaquine - therapeutic use
Antimalarials - therapeutic use
Biological and medical sciences
Child
Child, Preschool
chloroquine
Chloroquine - therapeutic use
Drug Combinations
Drug therapy
Drug Therapy, Combination
Female
Human protozoal diseases
Humans
Infant
Infectious diseases
Malaria
Malaria, Falciparum - drug therapy
Male
Medical sciences
Parasitic diseases
Plasmodium falciparum
Protozoal diseases
Pyrimethamine - therapeutic use
resistance
Sudan
Sulfadoxine - therapeutic use
sulphadoxine–pyrimethamine
Treatment Outcome
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Summary:Summary To provide advice on the rational use of antimalarial drugs, Médecins Sans Frontières conducted a randomized, an open label efficacy study in Kajo Keji, an area of high transmission of malaria in southern Sudan. The efficacy of chloroquine (CQ), sulphadoxine–pyrimethamine (SP) and amodiaquine (AQ) were measured in a 28‐day in vivo study, with results corrected by PCR genotyping. Of 2010 children screened, 115 children aged 6–59 months with uncomplicated Plasmodium falciparum malaria were randomized into each group to receive a supervised course of treatment. Of these, 114, 103 and 111 were analysed in the CQ, SP and AQ groups, respectively. The overall parasitological failure rates at day 28 were 93.9% [95% confidence interval (CI) 87.3–97.3] for CQ, 69.9% (95% CI 60.0–78.3) for SP, and 25.2% (95% CI 17.7–34.5) for AQ. These results provide important missing data on antimalarial drug efficacy in southern Sudan. They indicate that none of the drugs could be used in monotherapy and suggest that even in combination with artemisinin, cure rates might not be efficacious enough. We recommend a combination of artemether and lumefantrine as first‐line treatment for uncomplicated P. falciparum malaria cases in Kajo Keji county.
ISSN:1360-2276
1365-3156
DOI:10.1111/j.1365-3156.2004.01290.x