Abstract
BackgroundIn view of the high level of chloroquine resistance in many countries, WHO has recommended the use of combination therapy with artemisinin derivatives in the treatment of uncomplicated malaria due to Plasmodium falciparum. Four antimalarial drug combinations, artesunate plus amodiaquine (Arsucam®), artesunate plus mefloquine (Artequin®), artemether plus lumefantrine (Coartem®; four doses and six doses), and amodiaquine plus sulphadoxine-pyrimethamine, were studied in five health districts in Senegal.MethodsThis is a descriptive, analytical, open, randomized study to evaluate the efficacy and tolerability of these four antimalarial combinations in the treatment of uncomplicated falciparum malaria using the 2002 WHO protocol.ResultsAll drug combinations demonstrated good efficacy. On day 28, all combinations resulted in an excellent clinical and parasitological response rate of 100% after correction for PCR results, except for the four-dose artemether-lumefantrine regimen (96.4%). Follow-up of approximately 10% of each treatment group on day 42 demonstrated an efficacy of 100%.The combinations were well tolerated clinically and biologically. No unexpected side-effect was observed and all side-effects disappeared at the end of treatment. No serious side-effect requiring premature termination of treatment was observed.ConclusionThe four combinations are effective and well-tolerated.
Highlights
In view of the high level of chloroquine resistance in many countries, WHO has recommended the use of combination therapy with artemisinin derivatives in the treatment of uncomplicated malaria due to Plasmodium falciparum
The development and rapid increase of chloroquine resistance in many countries led the World Health Organization to organize a technical consultation in April 2001[4], during which the association of two antimalarial drugs was recommended for the treatment of uncomplicated malaria, those combining a classical antimalarial with an artemisinin derivative; such combinations are referred to as Artemisinin Combination Therapy (ACT)
Evaluation of combined therapy with amodiaquine plus sulphadoxine-pyrimethamine (SP) was done; these latter antimalarial drugs are readily available in Senegal and were in use as a therapeutic strategy at the time of the study
Summary
In view of the high level of chloroquine resistance in many countries, WHO has recommended the use of combination therapy with artemisinin derivatives in the treatment of uncomplicated malaria due to Plasmodium falciparum. The efficacy, safety and tolerability of three ACT for the treatment of malaria in Senegal were evaluated : artesunate plus amodiaquine (Arsucam®), artesunate plus mefloquine (Artequin®), and artemether plus lumefantrine (Coartem®; four doses and six doses). The objectives of the study were to evaluate the clinical and biological efficacy, safety and tolerability of these combinations in the treatment of uncomplicated malaria due to Plasmodium falciparum in Senegal, in order to generate data which could be used to determine the most effective antimalarial treatment policy
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