Comparison of the therapeutic efficacy of chloroquine and sulphadoxine-pyremethamine in children and pregnant women


Tagbor, H; Bruce, J; Ord, R; Randall, A; Browne, E; Greenwood, B; Chandramohan, D; (2007) Comparison of the therapeutic efficacy of chloroquine and sulphadoxine-pyremethamine in children and pregnant women. Tropical medicine & international health, 12 (11). pp. 1288-1297. ISSN 1360-2276 DOI: https://doi.org/10.1111/j.1365-3156.2007.01927.x

Full text not available from this repository. (Request a copy)

Abstract

OBJECTIVE To compare the parasitological failure rates of under-fives and pregnant women with parasitaemia treated with chloroquine (CQ) or sulphadoxine-pyrimethamine (SP). METHODS During a clinical trial of CQ SP, amodiaquine (AQ) and SP plus AQ combination for malaria treatment in pregnant women in Ghana, a parallel study of treatment of children below 5 years of age with symptomatic malaria with CQ and SP was undertaken. Four hundred and fifty pregnant women with malaria parasitaemia and 203 children with malaria parasitaemia were randomized to receive CQ or SP. They were followed up and parasitological failure by days 14 and 28 after the start of treatment was assessed. RESULTS Polymerase chain reaction (PCR)-uncorrected parasitological failure rates by day 28 after the start of treatment with CQ were 58.5% (55/94), 38.5% (45/117), 31% (13/42) and 8.2% (4/49) in children, primigravidae, secundigravidae and multigravidae, respectively. For those treated with SP the rates by day 28 were 36.4% (32/88), 27.1% (29/107), 6.1% (3/49) and 3.8% (2/52) in children, primigravidae, secundigravidae and multigravidae, respectively. In both CQ and SP treatment arms, children were twice as likely to experience recrudescence as pregnant women (RR 2.1 [95% CI 1.6-2.6] P < 0.0001) by day 28 after the start of treatment. CONCLUSIONS Parasitological failure rates were significantly lower in asymptomatic pregnant women, particularly in multigravidae, compared with symptomatic children. Reliance on drug sensitivity results observed in children only to decide on antimalarial regimes for pregnant women may not be appropriate.

Item Type: Article
Keywords: Antimalarials, therapeutic use, Child, Preschool, Chloroquine, therapeutic use, Drug Combinations, Female, Humans, Malaria, Falciparum, blood, drug therapy, Polymerase Chain Reaction, Pregnancy, Pregnancy Complications, Parasitic, drug therapy, Pyrimethamine, therapeutic use, Sulfadoxine, therapeutic use, Treatment Failure
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Malaria Centre
Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 17949398
Web of Science ID: 251716900003
URI: http://researchonline.lshtm.ac.uk/id/eprint/7897

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
338Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item