Abstract | BACKGROUND:
Sulfadoxine-pyrimethamine (S/P) is widely used for treatment of failures following the first line treatment for malaria in Africa. In Guinea-Bissau, it has been recommended as second line therapy by the National Malaria Programme since 1996. In order to monitor any change of the in vivo sensitivity, the efficacy of S/P was studied immediately before the introduction of the drug and 6-9 years later. METHODS: Children participating in clinical in vivo studies were given S/P if having late clinical treatment failure following the treatment with quinine, chloroquine, or amodiaquine. Parasitological and clinical failures were evaluated during a 35-day follow-up. During the first study period whole blood sulfadoxine concentrations were measured on day 7. RESULTS: Altogether, 56 children failed the initial treatment and were included in 1995/1996 as well as 55 children in 2002/2004. The PCR-uncorrected adequate clinical and parasitological response rates on day 28 were 94% and 91%, and on day 35 they were 89% and 91%, respectively, in the two periods. No difference between median blood drug concentration in children with and without treatment failure was observed. INTERPRETATION: The efficacy of S/P as second line treatment for uncomplicated malaria has remained unchanged in spite of a relatively high level of genetic markers associated with Plasmodium falciparum resistance to S/P previously found in the area.
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Authors | Poul-Erik Kofoed, Amabelia Rodrigues, Peter Aaby, Lars Rombo |
Journal | Acta tropica
(Acta Trop)
Vol. 100
Issue 3
Pg. 213-7
(Dec 2006)
ISSN: 0001-706X [Print] Netherlands |
PMID | 17173847
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antimalarials
- Drug Combinations
- Tablets
- Sulfadoxine
- Pyrimethamine
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Topics |
- Adolescent
- Animals
- Antimalarials
(administration & dosage)
- Child
- Child, Preschool
- Drug Combinations
- Female
- Guinea-Bissau
- Humans
- Infant
- Malaria, Falciparum
(drug therapy, metabolism)
- Male
- Parasitemia
- Plasmodium falciparum
- Pyrimethamine
(administration & dosage)
- Sulfadoxine
(administration & dosage, pharmacokinetics)
- Tablets
(administration & dosage)
- Treatment Failure
- Urban Population
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