Therapeutic efficacy of amodiaquine against uncomplicated malaria in Madagascar

Abstract

We report the results of a preliminary study carried out in 2004 to assess the therapeutic efficacy of amodiaquine in patients aged 5 years or older in Sainte Marie and Saharevo, in eastern Madagascar. Consenting patients with uncomplicated Plasmodium falciparum malaria were enrolled and followed up for 14 days: 46 were treated with chloroquine (25 mg/kg for 3 days) and 25 with amodiaquine (30 mg/kg for 3 days). No early treatment failure was observed with chloroquine but the overall late treatment failure rate was 17.4% (4.4% late clinical failures and 13% late parasitological failures). Amodiaquine was not associated with any cases of treatment failure through day 14. These preliminary results indicate that compared with chloroquine, amodiaquine is significantly more effective in treating uncomplicated malaria in our study sites. Amodiaquine is therefore recommended in combination with other antimalarial drugs. To generate useful data for decisions about drug use, further studies based on the WHO protocol should assess the clinical efficacy and also the safety of amodiaquine-containing antimalarial drugs in different regions in Madagascar, especially among children under 5 years.