We report the results of a preliminary study carried out in 2004 to assess the therapeutic efficacy of
amodiaquine in patients aged 5 years or older in Sainte Marie and Saharevo, in eastern Madagascar. Consenting patients with uncomplicated
Plasmodium falciparum malaria were enrolled and followed up for 14 days: 46 were treated with
chloroquine (25 mg/kg for 3 days) and 25 with
amodiaquine (30 mg/kg for 3 days). No early treatment failure was observed with
chloroquine but the overall late treatment failure rate was 17.4% (4.4% late clinical failures and 13% late parasitological failures).
Amodiaquine was not associated with any cases of treatment failure through day 14. These preliminary results indicate that compared with
chloroquine,
amodiaquine is significantly more effective in treating uncomplicated
malaria in our study sites.
Amodiaquine is therefore recommended in combination with other
antimalarial drugs. To generate useful data for decisions about
drug use, further studies based on the WHO protocol should assess the clinical efficacy and also the safety of
amodiaquine-containing
antimalarial drugs in different regions in Madagascar, especially among children under 5 years.