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- Title
Is amodiaquine failing in Rwanda? Efficacy of amodiaquine alone and combined with artesunate in children with uncomplicated malaria.
- Authors
Rwagacondo, Claude E.; Karema, Corine; Mugisha, Veronique; Erhart, Annette; Dujardin, Jean-Claude; Overmeir, Chantal Van; Ringwald, Pascal; D'Alessandro, Umberto
- Abstract
We investigated the safety and efficacy of amodiaquine alone (AQ) and combined with artesunate (AQ + AS) in 308 Rwandan children 6–59 months old with uncomplicatedPlasmodium falciparummalaria attending three sentinel sites. The two treatment regimes were well tolerated and no serious adverse events were recorded. After excluding new infections, children treated with AQ + AS had fewer clinical failures at day 28 after treatment than those treated with AQ alone: OR = 0.20 [95% CI: 0.06–0.57 (P = 0.001)]. Total (parasitological and clinical) failure was also significantly less frequent in the AQ + AS group: OR = 0.34 [95% CI: 0.17–0.67 (P = 0.001)]. When adjusting for study site, the hazard ratio for treatment failure was 0.37 [95% CI: 0.20–0.68 (P = 0.001)]. Combining AQ with AS increases the efficacy of the treatment but the apparent increase of AQ resistance observed in just a 1-year period is worrying and casts doubts on the suitability of implementing AQ + AS as first-line treatment in Rwanda. Alternative treatments should be identified and tested.
- Subjects
RWANDA; MALARIA treatment; JUVENILE diseases; ANTIMALARIALS; DRUG efficacy; COMBINATION drug therapy
- Publication
Tropical Medicine & International Health, 2004, Vol 9, Issue 10, p1091
- ISSN
1360-2276
- Publication type
Article
- DOI
10.1111/j.1365-3156.2004.01316.x