Abstract |
Resistance to chloroquine (CQ) requires its replacement as first-line therapy for uncomplicated malaria in much of Africa. Combination therapy may improve efficacy and delay the selection of resistant malaria parasites. Combinations of sulfadoxine-pyrimethamine (SP) with 4-aminoquinolines offer affordable and available alternatives to CQ. We conducted a randomized, single-blinded trial to compare the efficacy of SP monotherapy with combinations of SP and either CQ or amodiaquine (AQ) for the treatment of uncomplicated falciparum malaria in patients over 6 months of age in Kampala, Uganda. Of the 448 patients enrolled, 428 (95%) completed follow-up. Clinical treatment failure after 14 days occurred in 21/140 (15.0%, 95% CI 9.5-22.0%) SP-treated, 11/152 (7.2%, 95% CI 3.7-12.6%) SP/CQ-treated, and 0/136 (0%, 95% CI 0-2.7%) SP/AQ-treated patients. Combination therapies were safe and offered superior efficacy to SP monotherapy. SP/AQ was the most efficacious. This low-cost combination regimen may provide an optimal alternative to CQ for the treatment of uncomplicated malaria in Uganda.
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Authors | Anne F Gasasira, Grant Dorsey, Bridget Nzarubara, Sarah G Staedke, Annette Nassali, Philip J Rosenthal, Moses R Kamya |
Journal | The American journal of tropical medicine and hygiene
(Am J Trop Med Hyg)
Vol. 68
Issue 2
Pg. 127-32
(Feb 2003)
ISSN: 0002-9637 [Print] United States |
PMID | 12641399
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Antimalarials
- Drug Combinations
- Amodiaquine
- fanasil, pyrimethamine drug combination
- Sulfadoxine
- Chloroquine
- Pyrimethamine
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Topics |
- Adolescent
- Adult
- Amodiaquine
(administration & dosage, therapeutic use)
- Antimalarials
(administration & dosage, therapeutic use)
- Child
- Child, Preschool
- Chloroquine
(administration & dosage, therapeutic use)
- Drug Combinations
- Drug Therapy, Combination
- Female
- Humans
- Infant
- Malaria, Falciparum
(drug therapy)
- Male
- Middle Aged
- Pyrimethamine
(administration & dosage, therapeutic use)
- Single-Blind Method
- Sulfadoxine
(administration & dosage, therapeutic use)
- Treatment Outcome
- Uganda
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