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The effects of artemether-lumefantrine vs amodiaquine-sulfalene-pyrimethamine on the hepatomegaly associated with Plasmodium falciparum malaria in children.

Abstract
An open randomized controlled study of artemether-lumefantrine (AL) and amodiaquine-sulfalene-pyrimethamine (ASP) for the treatment of uncomplicated Plasmodium falciparum malaria was carried out in 181 children. In 79 children, the hepatomegaly reduction ratios (HRR) and the speed of resolution of hepatomegaly, the hepatomegaly resolution rates (HRSR), were calculated and compared between the two treatment groups. HRR and HRSR were similar in the two treatment groups. HRSR was 71% and 62% in AL- and ASP-treated children, respectively, 14 days after commencing treatment. There was no significant correlation between HRR and parasite reduction ratio in the same patient. In children in whom parasitaemia cleared and hepatomegaly resolved within 14 days, recurrence of parasitaemia was associated with reoccurrence of hepatomegaly, suggesting that the propensity for recurrence of infection drives the malaria-attributable hepatomegaly in children from this endemic area. Combination therapy may provide additional beneficial effects on pathophysiological processes and changes associated with falciparum malaria by rapid clearing of asexual parasitaemia and reducing the propensity for recurrence of infection.
AuthorsA Sowunmi, G O Gbotosho, A A Adedeji, E Tambo, B A Fateye, C T Happi, A O J Amoo
JournalParasitology research (Parasitol Res) Vol. 100 Issue 3 Pg. 511-7 (Feb 2007) ISSN: 0932-0113 [Print] Germany
PMID17013650 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antimalarials
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins
  • Drug Combinations
  • Ethanolamines
  • Fluorenes
  • Amodiaquine
  • Sulfalene
  • Pyrimethamine
Topics
  • Amodiaquine (administration & dosage, pharmacology, therapeutic use)
  • Animals
  • Antimalarials (administration & dosage, pharmacology, therapeutic use)
  • Artemether, Lumefantrine Drug Combination
  • Artemisinins (administration & dosage, pharmacology, therapeutic use)
  • Child
  • Child, Preschool
  • Drug Combinations
  • Drug Therapy, Combination
  • Ethanolamines (administration & dosage, pharmacology, therapeutic use)
  • Female
  • Fluorenes (administration & dosage, pharmacology, therapeutic use)
  • Hepatomegaly (complications, drug therapy)
  • Humans
  • Malaria, Falciparum (complications, drug therapy, pathology)
  • Male
  • Pyrimethamine (administration & dosage, pharmacology, therapeutic use)
  • Sulfalene (administration & dosage, pharmacology, therapeutic use)
  • Time Factors
  • Treatment Outcome

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