Artesunate-amodiaquine treatment for children with uncomplicated malaria in Kalimantan and Sulawesi: clinical complaints, tolerability and compliance

Abstract

Background Artesunate-amodiaquine combination (AS+ AQ) is one type of artemisinin-based combination therapy (ACT) and has been used in Indonesia since 2004 for uncomplicated malaria, both in adults and children. However, its use in the Indonesia Malaria Program has not yet been evaluated. Objective To evaluate the clinical complaints and tolerability to AS+AQ treatment, as well as compliance in children with uncomplicated malaria. Methods This was a cross-sectional study, conducted in sentinel puskesmas (primary health centers) in Kalimantan and Sulawesi. Subjects were 126 children aged under 15 years, with P. falciparum, P. vivax, or mixed falciparum-vivax malaria infections. All subjects were treated with a single dose of AS+AQ for three consecutive days and followed-up 3 times (D3, D7 and D28) to record clinical complaints and tolerability after drug administration. Parents/ guardians underwent in-depth interviews on the knowledge, attitudes and practices of the ACT used as well as clinical complaints following AS+ AQ treatment. Results Of the 126 subjects evaluated, 30 were infected with P. falciparum, 5 9 with P. vivax, and 3 7 with both species. About 84% of the subjects reported clinical complaints after AS+ AQ administration (DO-DZ), most commonly lethargy, nausea and vomiting, similar to the clinical symptoms of malaria. All complaints were reported to be mild and tolerable. Only one subject was lost to follow-up. Conclusion Clinical complaints experienced by malaria-infected children following AS+AQ treatment were relatively tolerable. Subjects' compliance to AS+ AQ treatment was satisfactory. [Paediatr lndones. 2012;52:10-5).

Keywords

• ACT
• artesunate-amodiaquine
• malaria
• children
• clinical complaint