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.
References
Jun 1, 1994·The American Journal of Tropical Medicine and Hygiene·T R GuiguemdeL Lamizana
Jun 15, 1996·Lancet·R N PriceN J White
Sep 30, 1998·Lancet·K Marsh
Oct 14, 1998·Comptes rendus de l'Académie des sciences. Série III, Sciences de la vie·J F TrapeF Simondon
May 29, 1999·The American Journal of Tropical Medicine and Hygiene·R PriceF Nosten
Jun 17, 1999·Lancet·N J WhiteP Olliaro
Jul 14, 1999·The American Journal of Tropical Medicine and Hygiene·R PriceN J White
Jul 27, 1999·Lancet·F I Konotey-Ahulu
Feb 9, 2000·Lancet·L von SeidleinT Doherty
May 17, 2000·The American Journal of Tropical Medicine and Hygiene·V RobertJ F Trape
Nov 9, 2000·Lancet·F NostenN J White
Nov 10, 2000·Lancet·I R Edwards, J K Aronson
Aug 15, 2001·Lancet·S G StaedkeP J Rosenthal
Apr 30, 2002·Lancet·M AdjuikW R J Taylor
Citations
Sep 24, 2005·Malaria Journal·Peter E MeissnerOlaf Müller
Jun 17, 2006·Malaria Journal·Sheick Oumar CoulibalyPascal Magnussen
Apr 19, 2008·Malaria Journal·Germain MandiOlaf Müller
Mar 18, 2009·Malaria Journal·Sodiomon B SirimaWalter R J Taylor
Jun 7, 2007·PLoS Medicine·Bocar KouyatéOlaf Müller
Oct 23, 2010·PloS One·Valérie AndriantsoanirinaDidier Ménard
Jun 28, 2007·Expert Opinion on Investigational Drugs·Sodiomon Bienvenu Sirima, Adama Gansané
Feb 12, 2008·Médecine et maladies infectieuses·A OuédraogoS B Sirima
Oct 2, 2007·Acta Tropica·Peter E MeissnerOlaf Müller
Feb 16, 2007·Tropical Medicine & International Health : TM & IH·Kefas MugittuWalter R J Taylor
Aug 26, 2006·Tropical Medicine & International Health : TM & IH·Kefas MugittuHans-Peter Beck
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
Sep 4, 2019·PloS One·Trond HaugmarkHeidi A Zangi
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