TY - JOUR
T1 - Comparison of the parasitologic efficacy of amodiaquine and sulfadoxine-pyrimethamine in the treatment of Plasmodium falciparum malaria in the Bungoma district of western Kenya
AU - Vreugdenhil, C. J.
AU - Scheper, F. Y.
AU - Hoogstraatte, S. R.
AU - Smolders, M.
AU - Gikunda, S.
AU - Cobelens, F. G.
AU - Kager, P. A.
PY - 2004
Y1 - 2004
N2 - The efficacy of amodiaquine (AQ) and sulfadoxine-pyrimethamine (SP) was assessed in 31, 0 symptomatic children from western Kenya with uncomplicated Plasmodium falciparum malaria. A non-blinded, randomized, 14-day study was performed and parasitologic criteria were used. Of 310 patients included, 238 (77%) completed the study: 120 received AQ and 118 received SP. In those treated with AQ, there were sensitive (S) infections in 107 patients (89.2%, 95% confidence interval [CI] = 82.2, 94.1%), RI resistance in 10 (8.3%, 95% CI = 4.1, 14.8%), RII resistance in 1 (0.8%, 95% CI = 0, 4.6%), and RIII resistance in 2 (1.7%, 95% CI = 0.2,5.9%). In those treated with SP, there were S infections in 74 patients (62.7%, 95% CI = 53.3, 71.4%), RI resistance in 21 (17.8%, 95% CI = 11.4, 25.9%), RII resistance in 11 (9.3%, 95% CI = 4.7,16.1%), and RIII resistance in 12 (10.2%, 95% CI = 5.4,17.1%). Resistance rates were consistently higher in the SP-treated patients (P <0.001). Resistance to SP in this area has reached such levels that it should no longer be the first-line treatment. Alternative treatment, such as SP plus AQ combination treatment or artemisinin combination treatment, is urgently needed
AB - The efficacy of amodiaquine (AQ) and sulfadoxine-pyrimethamine (SP) was assessed in 31, 0 symptomatic children from western Kenya with uncomplicated Plasmodium falciparum malaria. A non-blinded, randomized, 14-day study was performed and parasitologic criteria were used. Of 310 patients included, 238 (77%) completed the study: 120 received AQ and 118 received SP. In those treated with AQ, there were sensitive (S) infections in 107 patients (89.2%, 95% confidence interval [CI] = 82.2, 94.1%), RI resistance in 10 (8.3%, 95% CI = 4.1, 14.8%), RII resistance in 1 (0.8%, 95% CI = 0, 4.6%), and RIII resistance in 2 (1.7%, 95% CI = 0.2,5.9%). In those treated with SP, there were S infections in 74 patients (62.7%, 95% CI = 53.3, 71.4%), RI resistance in 21 (17.8%, 95% CI = 11.4, 25.9%), RII resistance in 11 (9.3%, 95% CI = 4.7,16.1%), and RIII resistance in 12 (10.2%, 95% CI = 5.4,17.1%). Resistance rates were consistently higher in the SP-treated patients (P <0.001). Resistance to SP in this area has reached such levels that it should no longer be the first-line treatment. Alternative treatment, such as SP plus AQ combination treatment or artemisinin combination treatment, is urgently needed
M3 - Article
C2 - 15569779
SN - 0002-9637
VL - 71
SP - 537
EP - 541
JO - American journal of tropical medicine and hygiene
JF - American journal of tropical medicine and hygiene
IS - 5
ER -