Randomized Comparison of Amodiaquine plus Sulfadoxine-Pyrimethamine, Artemether-Lumefantrine, and Dihydroartemisinin-Piperaquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Burkina Faso

Nov 9, 2007Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Comparing three malaria treatments for uncomplicated Plasmodium falciparum infection in Burkina Faso

AI simplified

Longevity & Aging on OpenScience ↗PubMed ↗DOI ↗

Abstract

The day 28 risk of recurrent malaria was 20.1% for patients receiving artemether-lumefantrine compared to 6.2% for amodiaquine plus sulfadoxine-pyrimethamine.

Amodiaquine plus sulfadoxine-pyrimethamine and dihydroartemisinin-piperaquine showed lower rates of recurrent parasitemia compared to artemether-lumefantrine.
Early treatment failures were reported in 5 patients on amodiaquine plus sulfadoxine-pyrimethamine and 2 patients on each of the other regimens.
Recrudescences of malaria were uncommon, occurring in less than 5% of patients across all treatment groups.
All regimens effectively cleared the malaria infection, but amodiaquine plus sulfadoxine-pyrimethamine and dihydroartemisinin-piperaquine were associated with better outcomes than artemether-lumefantrine.
No serious adverse events were noted during the study.

AI simplified

BACKGROUND: Combination antimalarial therapy is advocated to improve treatment efficacy and limit selection of drug-resistant parasites. We compared the efficacies of 3 combination regimens in Bobo-Dioulasso, Burkina Faso: amodiaquine plus sulfadoxine-pyrimethamine, which was recently shown to be highly efficacious at this site; artemether-lumefantrine, the new national first-line antimalarial regimen; and dihydroartemisinin-piperaquine (DP), a newer regimen.

METHODS: We enrolled 559 patients >or=6 months of age with uncomplicated Plasmodium falciparum malaria and randomized them to the 3 regimens. We analyzed the risk of recurrent parasitemia by day 28 and day 42, both unadjusted and adjusted by PCR methods to distinguish recrudescence and new infection.

RESULTS: Complete data were available for 517 (92.5%) of the enrolled subjects. Early treatment failures occurred in 5 patients treated with amodiaquine plus sulfadoxine-pyrimethamine and in 2 patients each treated with the other regimens. The day 28 risk of recurrent parasitemia, unadjusted by genotyping, was significantly higher for patients receiving artemether-lumefantrine than for patients receiving amodiaquine plus sulfadoxine-pyrimethamine (20.1% vs. 6.2%; risk difference, 13.8%; 95% confidence interval, 7.0%-20.7%) or dihydroartemisinin-piperaquine (20.1% vs. 2.2%; risk difference, 17.9%; 95% confidence interval, 11.6%-24.1%). Similar differences were seen for children <5 years of age (54% of the study population) and when outcomes were extended to 42 days. Significant differences were not seen between outcomes for patients receiving amodiaquine plus sulfadoxine-pyrimethamine and outcomes for those receiving dihydroartemisinin-piperaquine. Recrudescences were uncommon (occurring in <5% of patients) in all treatment groups. No serious adverse events were noted.

CONCLUSIONS: All regimens were highly efficacious in clearing infection, but considering the risks of recurrent malaria after therapy, the amodiaquine plus sulfadoxine-pyrimethamine and dihydroartemisinin-piperaquine regimens were more efficacious than the artemether-lumefantrine regimen (the new national regimen in Burkina Faso) for the treatment of uncomplicated P. falciparum malaria.

Full Text

Full text is available at the source.

View full text ↗

Randomized Comparison of Amodiaquine plus Sulfadoxine-Pyrimethamine, Artemether-Lumefantrine, and Dihydroartemisinin-Piperaquine for the Treatment of Uncomplicated Plasmodium falciparum Malaria in Burkina Faso

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the longevity & aging brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the longevity & aging brief