TY - JOUR
T1 - A randomized, placebo-controlled, double-blind trial on sulfadoxine-pyrimethamine alone or combined with artesunate or amodiaquine in uncomplicated malaria
AU - Mockenhaupt, Frank P.
AU - Ehrhardt, Stephan
AU - Dzisi, Stephen Y.
AU - Bousema, J. Teun
AU - Wassilew, Nasstasja
AU - Schreiber, Jonas
AU - Anemana, Sylvester D.
AU - Cramer, Jakob P.
AU - Otchwemah, Rowland N.
AU - Sauerwein, Robert W.
AU - Eggelte, Teunis A.
AU - Bienzle, Ulrich
PY - 2005/6
Y1 - 2005/6
N2 - The therapeutic efficacy of sulfadoxine-pynmethamine (SP) alone, SP plus amodiaquine (AQ), and SP plus artesunate (AS) was assessed in a randamized, placebo-controlled, and double-blind trial among 438 children with uncomplicated Plasmodium falciparum malaria in northern Ghana. Clinical and parasitological responses were monitored for 28 days following treatment; 86%, 98% and 97% of SP-, SP + AQ-, and SP + AS-treated patients achieved adequate clinical and parasitological response (ACPR) within 2 weeks, respectively. Parasite clearance was better with SP + AS than with SP or SP + AQ treatment but re-infections were more common. Polymerase chain reaction (PCR)-corrected rates of ACPR at day 28 were 72.2% for SP, 94.1% for SP + AQ (P < 0.0001), and 94.5% for SP + AS (P < 0.0001). Gametocyte prevalence and density 1 week after treatment were highest in children treated with SP, and lowest in patients receiving SP + AS. No severe adverse events attributable to study medication were observed. In northern Ghana, more than one of four children suffered SP treatment failure within 4 weeks. Both SP + AQ and SP + AS are efficacious alternative therapeutic options in this region. Although SP + AS and SP + AQ treatments have virtually identical cure rates, rapid parasite clearance and pronounced gametocidal effects are the advantages of the former, whereas cost and a lower rate of late re-infections are those of the latter.
AB - The therapeutic efficacy of sulfadoxine-pynmethamine (SP) alone, SP plus amodiaquine (AQ), and SP plus artesunate (AS) was assessed in a randamized, placebo-controlled, and double-blind trial among 438 children with uncomplicated Plasmodium falciparum malaria in northern Ghana. Clinical and parasitological responses were monitored for 28 days following treatment; 86%, 98% and 97% of SP-, SP + AQ-, and SP + AS-treated patients achieved adequate clinical and parasitological response (ACPR) within 2 weeks, respectively. Parasite clearance was better with SP + AS than with SP or SP + AQ treatment but re-infections were more common. Polymerase chain reaction (PCR)-corrected rates of ACPR at day 28 were 72.2% for SP, 94.1% for SP + AQ (P < 0.0001), and 94.5% for SP + AS (P < 0.0001). Gametocyte prevalence and density 1 week after treatment were highest in children treated with SP, and lowest in patients receiving SP + AS. No severe adverse events attributable to study medication were observed. In northern Ghana, more than one of four children suffered SP treatment failure within 4 weeks. Both SP + AQ and SP + AS are efficacious alternative therapeutic options in this region. Although SP + AS and SP + AQ treatments have virtually identical cure rates, rapid parasite clearance and pronounced gametocidal effects are the advantages of the former, whereas cost and a lower rate of late re-infections are those of the latter.
KW - Amodiaquine
KW - Artesunate
KW - Ghana
KW - Malaria
KW - Sulfadoxine-pyrimethamine
UR - http://www.scopus.com/inward/record.url?scp=20444416363&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=20444416363&partnerID=8YFLogxK
U2 - 10.1111/j.1365-3156.2005.01427.x
DO - 10.1111/j.1365-3156.2005.01427.x
M3 - Article
C2 - 15941413
AN - SCOPUS:20444416363
SN - 1360-2276
VL - 10
SP - 512
EP - 520
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 6
ER -