Molecular epidemiology of malaria in Cameroon. XXI. Baseline therapeutic efficacy of chloroquine, amodiaquine, and sulfadoxine-pyrimethamine monotherapies in children before national drug policy change.
Am J Trop Med Hyg
; 75(3): 388-95, 2006 Sep.
Article
en En
| MEDLINE
| ID: mdl-16968911
ABSTRACT
The availability of epidemiologic data on drug-resistant malaria based on a standardized clinical and parasitological protocol is a prerequisite for a rational therapeutic strategy to control malaria. As part of the surveillance program on the therapeutic efficacy of the first-line (chloroquine and amodiaquine) and second-line (sulfadoxine-pyrimethamine) drugs for the management of uncomplicated Plasmodium falciparum infections, non-randomized studies were conducted in symptomatic children aged less than 10 years according to the World Health Organization protocol (14-day follow-up period) at 12 sentinel sites in Cameroon between 1999 and 2004. Of 1,407 children enrolled in the studies, 460, 444, and 503 were treated with chloroquine, amodiaquine, or sulfadoxine-pyrimethamine, respectively. Chloroquine treatment resulted in high failure rates (proportion of early and late failures, 48.6%). Amodiaquine was effective at all study sites (proportion of failures, 7.3%). Sulfadoxine-pyrimethamine therapy was less effective than amodiaquine (P < 0.05), with failures observed in 9.9% of patients. Chloroquine is no longer a viable option and has been withdrawn from the official drug outlets in Cameroon. Amodiaquine and, to a lesser extent, sulfadoxine-pyrimethamine monotherapies are still effective in Cameroon, but further development of resistance to these drugs should be delayed by the novel strategy using artemisinin-based combination therapy. Our findings indicate that amodiaquine is the most rational partner for artesunate. Studies on the efficacy of artesunate-amodiaquine combination are currently being undertaken at several sites in the country.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pirimetamina
/
Sulfadoxina
/
Cloroquina
/
Malaria Falciparum
/
Epidemiología Molecular
/
Política de Salud
/
Amodiaquina
/
Antimaláricos
Tipo de estudio:
Clinical_trials
/
Guideline
/
Screening_studies
Límite:
Child
/
Humans
País/Región como asunto:
Africa
Idioma:
En
Revista:
Am J Trop Med Hyg
Año:
2006
Tipo del documento:
Article
País de afiliación:
Camerún