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http://hdl.handle.net/123456789/1767
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| Title: | Improved efficacy with amodiaquine instead of chloroquine in sulfadoxine/pyrimethamine combination treatment of falciparum malaria in Uganda: Experience with fixed-dose formulation |
| Authors: | Obua, C.
Gustafsson, L.L.
Aguttu, C.
Anokbonggo, W.W.
Ogwal-Okeng, J.W.
Chiria, J.
Hellgren, U. |
| Keywords: | Falciparum malaria
Plasmodium
Malaria
Antimalarial therapy (ART)
Uganda
Home Based Management (HBM)
Clinical trial
Amodiaquine
Chloroquine
Fixed-dose formulation |
| Issue Date: | 2006 |
| Publisher: | Elsevier |
| Citation: | Obua, C., Gustafsson, L.L., Aguttu, C., Anokbonggo, W.W., Ogwal-Okeng, J.W., Chiria, J., Hellgren, U. (2006). Improved efficacy with amodiaquine instead of chloroquine in sulfadoxine/pyrimethamine combination treatment of falciparum malaria in Uganda: Experience with fixed-dose formulation. Acta Tropica, 100 |
| Abstract: | Amodiaquine (AQ) is an affordable compound, chemically related to chloroquine (CQ) but often effective against CQ resistant
Plasmodium falciparum. In Uganda, a pre-packed fixed-dose combination of CQ plus sulfadoxine/pyrimethamine (CQ + SP) called
Homapak is used in the home based management of fever program (HBM).We performed a single blind randomized trial to determine
the efficacy of AQ+ SP in comparison with the fixed-dose CQ+ SP (Homapak) in the treatment of uncomplicated falciparum malaria
in Ugandan children aged 6 months to 5 years. The study was done in 2004 at Walkuba Health Center, a sub-urban area in Jinja
District, Uganda. Primary outcome was the day 14 per protocol clinical and parasitological response according to the WHO.
A total of 183 children were included (mean age 28 months) and 90% completed 28 days of follow up. The day 14 adequate clinical and parasitological response was 70.9% for CQ+ SP and 97.4% for AQ+ SP (p < 0.001). In those given CQ+ SP, treatment failure rates for the 6 months to 2 years age group were much higher (48.2%) than in the older children (18.2%, p = 0.004). The day 28 PCR adjusted parasitological failure rates were also higher in the CQ+ SP (31.3%) than in the AQ+ SP group (13.1%) (p = 0.003), with a higher gametocyte carriage among the CQ+ SP group.
We conclude that the efficacy of AQ+ SP was significantly superior to the fixed-dose CQ+ SP (Homapak), particularly among the
youngest children. Thus, AQ could be used instead of CQ in combination with SP to improve the effectiveness against falciparum
malaria in Uganda. |
| URI: | doi:10.1016/j.actatropica.2006.10.007
http://hdl.handle.net/123456789/1767 |
| ISSN: | 0001-706X |
| Appears in Collections: | Research Articles (Health-Sciences)
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