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Adding artesunate to sulphadoxine-pyrimethamine greatly improves the treatment efficacy in children with uncomplicated falciparum malaria on the coast of Benin, West Africa

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dc.contributor.author Nahum, A. en_US
dc.contributor.author Erhart, A. en_US
dc.contributor.author Gazard, D. en_US
dc.contributor.author Agbowai, C. en_US
dc.contributor.author Van Overmeir, C. en_US
dc.contributor.author van Loen, H. en_US
dc.contributor.author Menten, J. en_US
dc.contributor.author Okogbeto, M. en_US
dc.contributor.author Coosemans, M. en_US
dc.contributor.author Massougbodji, A. en_US
dc.contributor.author D'Alessandro, U. en_US
dc.date.accessioned 2008-03-12T14:41:24Z
dc.date.available 2008-03-12T14:41:24Z
dc.date.issued 2007
dc.identifier.issn 1475-2875
dc.identifier.doi http://dx.doi.org/10.1186/1475-2875-6-170
dc.identifier.other ITG-P2A en_US
dc.identifier.other ITG-P5B en_US
dc.identifier.other ITG-I6A en_US
dc.identifier.other ITG-I7A en_US
dc.identifier.other ITG-P9A en_US
dc.identifier.other ITG-PLA en_US
dc.identifier.other PARAS en_US
dc.identifier.other U-MALAR en_US
dc.identifier.other U-ENTOM en_US
dc.identifier.other INTER en_US
dc.identifier.other U-CTU en_US
dc.identifier.other JIF en_US
dc.identifier.other DOI en_US
dc.identifier.other URL en_US
dc.identifier.other UPD1 en_US
dc.identifier.other FTA en_US
dc.identifier.other ELECTRONIC en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.uri http://hdl.handle.net/10390/2166
dc.description.abstract BACKGROUND: Benin has recently shifted its national antimalarial drug policy from monotherapies to combinations containing artemisinin derivatives. When this decision was taken, the available information on alternatives to chloroquine and sulphadoxine-pyrimethamine, the first- and second-line treatment, was sparse. METHODS: In 2003 - 2005, before the drug policy change, a randomized, open-label, clinical trial was carried out on the efficacy of chloroquine, and sulphadoxine-pyrimethamine alone or combined with artesunate, with the aim of providing policy makers with the information needed to formulate a new antimalarial drug policy. Children between six and 59 months of age, with uncomplicated malaria and living in the lagoon costal area in southern Benin, were randomly allocated to one of the three study arms and followed up for 28 days. RESULTS: Treatment failure (PCR corrected) was significantly lower in the artesunate + sulphadoxine-pyrimethamine group (4/77, 5.3%) than in chloroquine group(51/71, 71.8%) or the sulphadoxine-pyrimethamine alone group (30/70, 44.1%) (p < 0.001). Despite high sulphadoxine-pyrimethamine failure, its combination with artesunate greatly improved treatment efficacy. CONCLUSION: In Benin, artesunate + sulphadoxine-pyrimethamine is efficacious and could be used when the recommended artemisinin-based combinations (artemether-lumefantrine and amodiaquine-artesunate) are not available. However, because sulphadoxine-pyrimethamine is also used in pregnant women as intermittent preventive treatment, its combination with artesunate should not be widely employed in malaria patients as this may compromise the efficacy of intermittent preventive treatment. en_US
dc.language English en_US
dc.publisher BioMed Central en_US
dc.subject Protozoal diseases en_US
dc.subject Malaria en_US
dc.subject Plasmodium falciparum en_US
dc.subject Drug therapy en_US
dc.subject First-line drugs en_US
dc.subject Sulfadoxine-pyrimethamine en_US
dc.subject Artesunate en_US
dc.subject Artemisinin combination therapies (ACT) en_US
dc.subject Children en_US
dc.subject Efficacy en_US
dc.subject Pregnancy en_US
dc.subject Chemoprophylaxis en_US
dc.subject Intermittent treatment en_US
dc.subject Benin en_US
dc.subject Africa, West en_US
dc.title Adding artesunate to sulphadoxine-pyrimethamine greatly improves the treatment efficacy in children with uncomplicated falciparum malaria on the coast of Benin, West Africa en_US
dc.type Article-E en_US
dc.citation.issue 170 en_US
dc.citation.jtitle Malaria Journal en_US
dc.citation.volume 6 en_US
dc.citation.pages 8 en_US
dc.publisher.place London en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/18154655
dc.identifier.url http://www.malariajournal.com/content/6/1/170
dc.citation.jabbreviation Malaria J en_US


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