Malaria Journal (Jan 2009)

Artemisinin-based combinations versus amodiaquine plus sulphadoxine-pyrimethamine for the treatment of uncomplicated malaria in Faladje, Mali

  • Traore Boubacar,
  • Saye Renion,
  • Guirou Etienne A,
  • Kone Younoussou,
  • Traore Hamidou,
  • Yattara Oumar,
  • Hoppe Annett,
  • McMorrow Meredith L,
  • Newman Robert D,
  • Maiga Hamma,
  • Kayentao Kassoum,
  • Djimde Abdoulaye,
  • Doumbo Ogobara K

DOI
https://doi.org/10.1186/1475-2875-8-5
Journal volume & issue
Vol. 8, no. 1
p. 5

Abstract

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Abstract Background Because of the emergence of chloroquine resistance in Mali, artemether-lumefantrine (AL) or artesunate-amodiaquine (AS+AQ) are recommended as first-line therapy for uncomplicated malaria, but have not been available in Mali until recently because of high costs. Methods From July 2005 to January 2006, a randomized open-label trial of three oral antimalarial combinations, namely AS+AQ, artesunate plus sulphadoxine-pyrimethamine (AS+SP), and amodiaquine plus sulphadoxine-pyrimethamine (AQ+SP), was conducted in Faladje, Mali. Parasite genotyping by polymerase chain reaction (PCR) was used to distinguish new from recrudescent Plasmodium falciparum infections. Results 397 children 6 to 59 months of age with uncomplicated Plasmodium falciparum malaria were enrolled, and followed for 28 days to assess treatment efficacy. Baseline characteristics were similar in all three treatment groups. The uncorrected rates of adequate clinical and parasitologic response (ACPR) were 55.7%, 90.8%, and 97.7% in AS+AQ, AS+SP, and AQ+SP respectively (p Conclusion The combination of AQ+SP provides a potentially low cost alternative for treatment of uncomplicated P. falciparum infection in Mali and appears to have the added value of longer protective effect against new infection.