Abstract
BackgroundCongo-Brazzaville adopted artemisinin-based combination therapy (ACT) in 2006. Artesunate-amodiaquine (AS + AQ) and artemether-lumefantrine are the first-line and second-line anti-malarial drugs to treat uncomplicated Plasmodium falciparum malaria, respectively. The baseline efficacy of AS + AQ was evaluated from February to August 2005 in patients living in Brazzaville, the capital city of the Republic of Congo.MethodsOne hundred and ninety-seven patients (96 ≤5 years old and 101 >5 years old, including adults) were recruited in a non-randomized study, treated under supervision with AS + AQ, and were followed up for 28 days in accordance with the 2003 World Health Organization protocol. Plasmodium falciparum recrudescent isolates from day 7 to day 28 were compared to pretreatment isolates by polymerase chain reaction (PCR) to distinguish between re-infection and recrudescence.ResultsThe overall efficacy of AS + AQ after PCR correction on day 28 was 94.4%. An adequate clinical and parasitological response was observed in 94.3% and 94.4% of children aged ≤5 years old and those aged >5 years old (including adults), respectively. The main reported adverse events were dizziness, vomiting, diarrhoea, pruritus, headache, anorexia, and abdominal pain.ConclusionThis study has shown the high efficacy of AS + AQ in Congolese patients of all ages with acute uncomplicated falciparum malaria and serves as the baseline efficacy and tolerance of this ACT in Brazzaville.
Highlights
Congo-Brazzaville adopted artemisinin-based combination therapy (ACT) in 2006
In the health centres of Brazzaville, the capital city of the Republic of Congo, 22 to 45.7% of febrile patients were infected with malaria parasites [13]
Baseline characteristics of recruited patients From February to August 2005, 1,087 febrile patients were screened for malaria in the urban Tenrikyo health centre, where 259 (23.8%) had a positive smear
Summary
Congo-Brazzaville adopted artemisinin-based combination therapy (ACT) in 2006. Artesunate-amodiaquine (AS + AQ) and artemether-lumefantrine are the first-line and second-line anti-malarial drugs to treat uncomplicated Plasmodium falciparum malaria, respectively. The baseline efficacy of AS + AQ was evaluated from February to August 2005 in patients living in Brazzaville, the capital city of the Republic of Congo. The end of the 20th Century was marked by a considerable increase in global malaria burden due to resistance of the parasites to anti-malarial drugs, in particular. Before implementation of ACT in the Republic of Congo, malaria was the third cause of medical consultation [12]. In the health centres of Brazzaville, the capital city of the Republic of Congo, 22 to 45.7% of febrile patients were infected with malaria parasites [13]. In the Department of Paediatrics of the main hospital of Brazzaville, Centre Hospitalo-Universitaire de Brazzaville, malaria represents one of the major causes of hospitalization and death [14,15,16]
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