Comparative efficacy of artesunate and sulphadoxine-pyrimethamine combination with artesunate and amodiaquine combination in uncomplicated falciparum malaria in children

Abstract

Background Malaria is still an important cause of mortality and morbidity in children and adults in tropical countries. Multidrug resistance againts chloroquine and sulphadox- ine-pyrimethamine had brought to an introduction of artemisinin-based combination. Objective To assess the alternative treatment of uncompli- cated falciparum malaria in children using artesunate and sulphadoxine-pyrimethamine combination comparing to artesunate and amodiaquine combination. Methods This is a single-blind randomized trial. Sixty- seven children aged six months to 13 years, were recruited. Thirty-three children were treated with artesunate 4 mg/ kgbw/day for three days with an additional sulphadoxine- pyrimethamine (pyrimethamine 1-1.5 mg/kgbw) single dose on the first day, while 34 children were treated with artesunate and amodiaquine base 10 mg/kgbw/day for the first two days, then 5 mg/kgbw/day on the third day. Body temperature and parasite count were recorded everyday for at least seven days. The outcomes were fever clearance time, parasite clearance time, cure rate and side effects. Sta- tistical analysis was performed using the student t-test. Results The statistical analysis showed that there were no difference between these two groups either in fever clearance time (P>0.05), or in parasite clearance time (P>0.05). The cure rate was 100% in both groups. Vomit- ing was found in one patient treated with artesunate and amodiaquine combination. Conclusion The combination of artesunate and sulpha- doxine-pyrimethamine and combination of artesunate and amodiaquine were found to be equally effective in the treatment of uncomplicated falciparum malaria in children

Keywords

• uncomplicated falciparum malaria
• artesunate
• sulphadoxine-pyrimethamine
• amodiaquine