Comparative efficacy of aminoquinoline-antifolate combinations for the treatment of uncomplicated falciparum malaria in Kampala, Uganda


Gasasira, AF; Dorsey, G; Nzarubara, B; Staedke, SG; Nassali, A; Rosenthal, PJ; Kamya, MR; (2003) Comparative efficacy of aminoquinoline-antifolate combinations for the treatment of uncomplicated falciparum malaria in Kampala, Uganda. The American journal of tropical medicine and hygiene, 68 (2). pp. 127-32. ISSN 0002-9637

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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.

Item Type: Article
Keywords: 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, 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
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Malaria Centre
PubMed ID: 12641399
Web of Science ID: 180994700002
URI: http://researchonline.lshtm.ac.uk/id/eprint/10204

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