COMBINATION OF ARTESUNATE-AMODIAQUINE AS A TREATMENT FOR UNCOMPLICATED FALCIPARUM MALARIA IN CHILDREN

Abstract

INTRODUCTION: Resistance of falciparum malaria to both chloroquine and pyrimethamine-sulfadoxine has been reported from Indonesia and other countries. Since the end of 2004, we have changed the standard treatment of uncomplicated falciparum malaria to use a combination of artesunate and amodiaquine. OBJECTIVE: Our aim was to evaluate the efficacy and adverse reactions of artesunate-amodiaquine as a treatment for uncomplicated falciparum malaria in children. METHODS: We conducted a cross-sectional study at Panyabungan, Mandailing Natal Regency, North Sumatera Province, Indonesia, from August to September 2006. The sample was school-aged children between 5 and 18 years old. The sample received an oral dose of artesunate (4 mg/kg body weight) combined with an oral dose of amodiaquine (10 mg/kg body weight) for 3 days. Parasitemia was assessed at days 0, 2, 7, and 28. RESULTS: Peripheral blood smears were performed for 376 school-aged children; 135 of them tested positive for falciparum malaria. At the end of the study (28 days), 121 cases completed a full course of study. From the peripheral blood smears on days 2, 7, and 28, we found a 100% cure rate. Adverse reactions included 20 children (16.5%) with headache, 10 (8.3%) with vomiting, and 1 (0.8%) with tinnitus. CONCLUSIONS: A combination of artesunate and amodiaquine can be used as treatment for uncomplicated falciparum malaria in children with the caution of headache as an adverse reaction of the drug combination.