Randomized Comparison of Chloroquine plus Sulfadoxine-Pyrimethamine versus Artesunate plus Mefloquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Falciparum Malaria in the Lao People's Democratic Republic

Oct 16, 2004Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Comparing three drug combinations for treating simple falciparum malaria in Laos

AI simplified

Longevity & Aging on OpenScience ↗PubMed ↗DOI ↗

Abstract

The 42-day cure rates for artesunate plus mefloquine, artemether-lumefantrine, and chloroquine plus sulfadoxine-pyrimethamine were 100%, 97%, and 93%, respectively.

Chloroquine and sulfadoxine-pyrimethamine are no longer effective for treating uncomplicated Plasmodium falciparum malaria in Laos.
Patients treated with chloroquine plus sulfadoxine-pyrimethamine had a significantly longer mean parasite clearance time of 2.9 days compared to 2.07 days for artesunate plus mefloquine and 2.08 days for artemether-lumefantrine.
Six out of eight treatment failures in the chloroquine plus sulfadoxine-pyrimethamine group were classified as early treatment failures.
Cure rates with artemether-lumefantrine remained high despite a low average daily dietary fat intake of 13.8 grams.

AI simplified

BACKGROUND: Recent clinical trials in the Lao People's Democratic Republic have demonstrated that chloroquine and sulfadoxine-pyrimethamine, which are national malaria treatment policy, are no longer effective in the treatment of uncomplicated Plasmodium falciparum malaria.

METHODS: A randomized comparison of 3 oral antimalarial combinations--chloroquine plus sulfadoxine-pyrimethamine versus artesunate plus mefloquine versus artemether-lumefantrine--with 42-day follow-up period, was conducted among 330 patients with acute uncomplicated falciparum malaria in southern Laos.

RESULTS: The 42-day cure rates, as determined by intention-to-treat analysis and adjusted for reinfection, were 100%, 97%, and 93% for the groups receiving artesunate plus mefloquine, artemether-lumefantrine, and chloroquine plus sulfadoxine-pyrimethamine, respectively. Of 8 patients receiving chloroquine plus sulfadoxine-pyrimethamine who experienced treatment failure, 6 had early treatment failure. The mean parasite clearance time was significantly longer in patients treated with chloroquine plus sulfadoxine-pyrimethamine (2.9 days; 95% confidence interval [CI], 2.8-3.0 days) than in those treated with artesunate plus mefloquine (2.07 days; 95% CI, 2.0-2.1 days; P<.001) and artemether-lumefantrine (2.08 days; 95% CI, 2.0-2.1 days; P<.001). Cure rates with artemether-lumefantrine were high despite low mean daily dietary fat intake (13.8 g; 95% CI, 12.5-15.1 g) and day 7 plasma lumefantrine concentrations (0.47 mu g/mL; 95% CI, 0.38-0.56 mu g/mL).

CONCLUSION: Oral artesunate plus mefloquine and artemether-lumefantrine are highly effective for the treatment of uncomplicated falciparum malaria in Laos.

Full Text

Full text is available at the source.

View full text ↗

Randomized Comparison of Chloroquine plus Sulfadoxine-Pyrimethamine versus Artesunate plus Mefloquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Falciparum Malaria in the Lao People's Democratic Republic

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