Efficacy of Artesunate Plus Amodiaquine for Treatment of Uncomplicated Clinical Falciparum Malaria in Severely Malnourished Children Aged 6–59 Months, Democratic Republic of Congo

P Mitangala Ndeba

doi:10.4172/2161-0681.s3-005

Abstract

Abstract Background: Recent published studies on efficacy and safety of antimalarial treatment in children with Severe Acute Malnutrition (SAM) suffering from uncomplicated malaria are not available. Methods: Between March 2007 and December 2010 the efficacy of AS+AQ in treating uncomplicated malaria children under five with SAM was carried out in Lwiro (Eastern Republic Democratic of Congo) according to the WHO standard protocol. Among the 445 children included, 69 had SAM. AS+AQ was given according to national protocol. Analysis was done using per protocol method. Odds ratio (OR) and their 95% confidence interval (95% CI) were computed. Results: The treatment failure rate was 24.4% of 414 infections included in the analysis. After adjustment for malaria parasitemia, ACPR in children without SAM were 73.0% when it was 91.4% among those with SAM (OR 3.15 95%CI 1.19 – 8.30). Malaria parasitemia median at admission was statistically low among children who had subsequently Adequate Clinical and Parasitological Response (ACPR). Conclusion: AS+AQ has a good efficacy among children with both uncomplicated falciparum malaria and malnutrition including severe acute form. AS+AQ dosing national strategy unmodified can be used, to treat under five children with malnutrition including severe acute form suffering from uncomplicated malaria.

Highlights

In Sub-Saharian African, malaria and malnutrition often co-exist and represent an important public health burden [1,2]
AS+AQ has a good efficacy among children with both uncomplicated falciparum malaria and malnutrition including severe acute form
AS+AQ dosing national strategy unmodified can be used, to treat under five children with malnutrition including severe acute form suffering from uncomplicated malaria

Summary

Introduction

In Sub-Saharian African, malaria and malnutrition often co-exist and represent an important public health burden [1,2]. Chloroquine (CQ), The most affordable and widely available antimalarial treatment in the past, has been replaced, according to the World Health Organization recommendations, by artemisinin-based combination treatments (ACT) [4,5]. This was followed by a strong advocating of the use of the ACT [6]. In Eastern Democratic Republic of Congo (DRC), resistance of Plasmodium falciparum to CQ has been documented since 1983 and was estimated at 80% in 2001 [7] This prompted the National Malaria Control Program (NMCP) to change in 2005 the national antimalarial treatment policy and the first line treatment, from CQ to amodiaquine plus artesunate (AS+AQ). Recent published studies on efficacy and safety of antimalarial treatment in children with Severe Acute Malnutrition (SAM) suffering from uncomplicated malaria are not available

Results

Discussion

Conclusion