المستودع الأكاديمي جامعة المدينة

Low efficacy of the combination artesunate plus amodiaquine for uncomplicated falciparum malaria among children under 5 years in Kailahun, Sierra Leone.

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dc.contributor Epicentre, Paris, France.
dc.creator Grandesso, F
dc.creator Hagerman, A
dc.creator Kamara, S
dc.creator Lam, E
dc.creator Checchi, F
dc.creator Balkan, S
dc.creator Scollo, G
dc.creator Durand, R
dc.creator Guthmann, J P
dc.date 2006-07
dc.date.accessioned 2017-01-31T07:09:28Z
dc.date.available 2017-01-31T07:09:28Z
dc.identifier Low efficacy of the combination artesunate plus amodiaquine for uncomplicated falciparum malaria among children under 5 years in Kailahun, Sierra Leone. 2006, 11 (7):1017-21 Trop. Med. Int. Health
dc.identifier 1360-2276
dc.identifier 16827702
dc.identifier 10.1111/j.1365-3156.2006.01655.x
dc.identifier http://hdl.handle.net/10144/17675
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/17675
dc.identifier Tropical Medicine & International Health
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/17675
dc.description OBJECTIVE: In 2004, Sierra Leone adopted artesunate plus amodiaquine as first-line antimalarial treatment. We evaluated the efficacy of this combination in Kailahun, where a previous study had shown 70.2% efficacy of amodiaquine in monotherapy. METHODS: Method and outcome classification of the study complied with WHO guidelines. Children 6-59 months with uncomplicated malaria were followed-up for 28 days. PCR genotyping was used to distinguish recrudescence from reinfection. Reinfections were reclassified as cured. RESULTS: Of 172 children who were referred to the study clinic, 126 satisfied inclusion criteria and were enrolled. No early treatment failures were reported. The day 14, efficacy was 98.2% (95% CI: 93.8-99.8). Of 65 recurrent parasitaemias analysed by PCR, 17 were recrudescences. The PCR-adjusted day 28 efficacy was 84.5% (95% CI: 76.4-90.7). All true failures occurred in the last 8 days of follow-up. Of 110 children who completed the 28-day follow-up, 54 (49.1%) experienced a novel infection. CONCLUSION: The efficacy of this combination was disappointing. The high reinfection rate suggested little prophylactic effect. In Kailahun a more efficacious combination might be necessary in the future. The efficacy of AS + AQ needs to be monitored in Kailahun and in the other regions of Sierra Leone.
dc.language en
dc.publisher Wiley-Blackwell
dc.relation http://www.blackwell-synergy.com/loi/tmi
dc.rights Archived on this site with the kind permission of Wiley-Blackwell
dc.title Low efficacy of the combination artesunate plus amodiaquine for uncomplicated falciparum malaria among children under 5 years in Kailahun, Sierra Leone.


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