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Artesunate and sulfadoxine-pyrimethamine combinations for the treatment of uncomplicated Plasmodium falciparum malaria in Uganda: a randomized, double-blind, placebo-controlled trial.

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dc.contributor Epicentre, 8 rue Saint Sabin, 75011 Paris, France. gpriotto@epicentre.msf.org
dc.creator Priotto, G
dc.creator Kabakyenga, J K
dc.creator Pinoges, L
dc.creator Ruiz, A
dc.creator Eriksson, T
dc.creator Coussement, F
dc.creator Ngambe, T
dc.creator Taylor, W R J
dc.creator Perea, W
dc.creator Guthmann, J P
dc.creator Olliaro, P
dc.creator Legros, D
dc.date 2008-01-25T15:48:35Z
dc.date.accessioned 2017-01-31T07:09:08Z
dc.date.available 2017-01-31T07:09:08Z
dc.identifier Artesunate and sulfadoxine-pyrimethamine combinations for the treatment of uncomplicated Plasmodium falciparum malaria in Uganda: a randomized, double-blind, placebo-controlled trial., 97 (3):325-30 Trans. R. Soc. Trop. Med. Hyg.
dc.identifier 0035-9203
dc.identifier 15228253
dc.identifier http://hdl.handle.net/10144/16896
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/16896
dc.identifier Transactions of the Royal Society of Tropical Medicine and Hygiene
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/16896
dc.description Drug-resistant malaria is spreading in Africa. The few available drugs might be safeguarded if combined with an artemisinin derivative. We investigated the efficacy, safety, and tolerability of 2 combinations of artesunate with sulfadoxine-pyrimethamine (SP) in a mesoendemic region in Uganda with SP resistance, from September 1999 to June 2000. In a randomized, double-blind, placebo-controlled trial, 420 children aged 6-59 months with uncomplicated Plasmodium falciparum malaria were assigned SP alone (25 mg/kg sulfadoxine, 1.25 mg/kg pyrimethamine) or combined with artesunate (AS; 4 mg/kg/d) for either 1 d (SPAS1) or 3 d (SPAS3). Children were followed-up for 28 d. Day 14 cure rates were 84.6% (99/117) with SPAS3 and 61.9% (73/118) with SPAS1 compared with 55.8% (86/154) with SP. Corresponding day 28 results were 74.4% (87/117) and 45.2% (52/115) compared with 40.5% (62/153). A significant improvement was obtained with the addition of 3 d, but not 1 d, of artesunate (risk ratio [RR] = 1.5, 95% CI 1.3-1.8 at 14 d and RR = 1.8, 95% CI 1.5-2.3 at 28 d). Both AS regimens achieved significantly faster parasite clearance and lower gametocyte carriage. All drug regimens were well tolerated, but SP alone was ineffective. Treatment efficacy improved with SPAS3 but the cure rate at day 28 was modest. The combinations were well tolerated and safe. In areas where SP resistance is prevalent other combinations should be considered.
dc.language en
dc.publisher Elsevier
dc.relation http://www.sciencedirect.com/science/journal/00359203
dc.rights Archived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.asp
dc.title Artesunate and sulfadoxine-pyrimethamine combinations for the treatment of uncomplicated Plasmodium falciparum malaria in Uganda: a randomized, double-blind, placebo-controlled trial.


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