Efficacy of artesunate plus chloroquine for the treatment of uncomplicated malaria in children in Burkina Faso: a double-blind, randomized, controlled trial

Transactions of the Royal Society of Tropical Medicine and Hygiene
Sodiomon B SirimaPiero L Olliaros

Abstract

Chloroquine (CQ)-resistant Plasmodium falciparum is compromising malaria control in Africa. Combining artesunate (AS) with standard antimalarial drugs increases cure rates and may delay drug resistance. We compared the safety and efficacy of CQ alone and CQ combined with AS (CQ-AS) for treating uncomplicated P. falciparum malaria in Burkina Faso between August 1999 and August 2000. Chloroquine (25 mg/kg over 3 d) combined with AS or placebo (4 mg/kg/d for 3 d) was administered to 300 children aged 6 to 59 months in a randomized, double-blind study. Follow-up extended over 28 d. No adverse drug reactions were recorded. By day 14, parasites were cleared in 120/147 (81.6%) CQ AS-treated children compared with 53/143 (37.1%) CQ-treated children (odds ratio [OR] = 7.55, 95% CI 4.27-13.43, P < 0.001). Corresponding rates for day 28 were 71/145 (49.0%) vs. 27/142 (19.0%) (OR= 4.09, 95% CI 2.33-7.21, P < 0.001). Children who received CQ-AS had significantly faster parasite and fever clearance. Despite the beneficial effects of adding AS, the high failure rate at day 28 of CQ-AS precludes its use as the first-line regimen for treating CQ-resistant P. falciparum in Burkina Faso.

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Citations

Jun 28, 2007·Expert Opinion on Investigational Drugs·Sodiomon Bienvenu Sirima, Adama Gansané
Feb 16, 2007·Tropical Medicine & International Health : TM & IH·Kefas MugittuWalter R J Taylor
Feb 4, 2012·Journal of Ethnopharmacology·Rakiswendé Serge YerbangaAnnette Habluetzel
Nov 16, 2012·The Cochrane Database of Systematic Reviews·Amanda C de C WilliamsStephen Morley
Sep 3, 2019·The Cochrane Database of Systematic Reviews·Soo Y KimJulia Bidonde
Oct 19, 2007·The Cochrane Database of Systematic Reviews·A J BuschC L Schachter
Dec 24, 2013·The Cochrane Database of Systematic Reviews·Angela J BuschTom J Overend
Oct 29, 2014·The Cochrane Database of Systematic Reviews·Julia BidondeTamara Rader
May 25, 2012·The Medical Journal of Australia·Kaveh Monshat, David J Castle
Jun 22, 2017·The Cochrane Database of Systematic Reviews·Julia BidondeHeather Ja Foulds

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