Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies
<p>Abstract</p> <p>Background</p> <p>Very few data on anti-malarial efficacy are available from the Democratic Republic of Congo (DRC). DRC changed its anti-malarial treatment policy to amodiaquine (AQ) and artesunate (AS) in 2005.</p> <p>Methods</p> &...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2009-08-01
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| Series: | Malaria Journal |
| Online Access: | http://www.malariajournal.com/content/8/1/192 |
| _version_ | 1818143281673928704 |
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| author | van Overmeir Chantal Urrutia Pedro van Herp Michel van den Broek Ingrid Bonnet Maryline Kyomuhendo Juliet Ndosimao Célestin Ashley Elizabeth Guthmann Jean-Paul |
| author_facet | van Overmeir Chantal Urrutia Pedro van Herp Michel van den Broek Ingrid Bonnet Maryline Kyomuhendo Juliet Ndosimao Célestin Ashley Elizabeth Guthmann Jean-Paul |
| author_sort | van Overmeir Chantal |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Very few data on anti-malarial efficacy are available from the Democratic Republic of Congo (DRC). DRC changed its anti-malarial treatment policy to amodiaquine (AQ) and artesunate (AS) in 2005.</p> <p>Methods</p> <p>The results of two in vivo efficacy studies, which tested AQ and sulphadoxine-pyrimethamine (SP) monotherapies and AS+SP and AS+AQ combinations in Boende (Equatorial province), and AS+SP, AS+AQ and SP in Kabalo (Katanga province), between 2003 and 2004 are presented. The methodology followed the WHO 2003 protocol for assessing the efficacy of anti-malarials in areas of high transmission.</p> <p>Results</p> <p>Out of 394 included patients in Boende, the failure rates on day 28 after PCR-genotyping adjustment of AS+SP and AS+AQ were estimated as 24.6% [95% CI: 16.6–35.5] and 15.1% [95% CI: 8.6–25.7], respectively. For the monotherapies, failure rates were 35.9% [95% CI: 27.0–46.7] for SP and 18.3% [95% CI: 11.6–28.1] for AQ. Out of 207 patients enrolled in Kabalo, the failure rate on day 28 after PCR-genotyping adjustment was 0 [1-sided 95% CI: 5.8] for AS+SP and AS+AQ [1-sided 95% CI: 6.2]. It was 19.6% [95% CI: 11.4–32.7] for SP monotherapy.</p> <p>Conclusion</p> <p>The finding of varying efficacy of the same combinations at two sites in one country highlights one difficulty of implementing a uniform national treatment policy in a large country. The poor efficacy of AS+AQ in Boende should alert the national programme to foci of resistance and emphasizes the need for systems for the prospective monitoring of treatment efficacy at sentinel sites in the country.</p> |
| first_indexed | 2024-12-11T11:29:11Z |
| format | Article |
| id | doaj.art-1dd39125cd3647a7933a122b2a9a9072 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-11T11:29:11Z |
| publishDate | 2009-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-1dd39125cd3647a7933a122b2a9a90722022-12-22T01:08:55ZengBMCMalaria Journal1475-28752009-08-018119210.1186/1475-2875-8-192Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studiesvan Overmeir ChantalUrrutia Pedrovan Herp Michelvan den Broek IngridBonnet MarylineKyomuhendo JulietNdosimao CélestinAshley ElizabethGuthmann Jean-Paul<p>Abstract</p> <p>Background</p> <p>Very few data on anti-malarial efficacy are available from the Democratic Republic of Congo (DRC). DRC changed its anti-malarial treatment policy to amodiaquine (AQ) and artesunate (AS) in 2005.</p> <p>Methods</p> <p>The results of two in vivo efficacy studies, which tested AQ and sulphadoxine-pyrimethamine (SP) monotherapies and AS+SP and AS+AQ combinations in Boende (Equatorial province), and AS+SP, AS+AQ and SP in Kabalo (Katanga province), between 2003 and 2004 are presented. The methodology followed the WHO 2003 protocol for assessing the efficacy of anti-malarials in areas of high transmission.</p> <p>Results</p> <p>Out of 394 included patients in Boende, the failure rates on day 28 after PCR-genotyping adjustment of AS+SP and AS+AQ were estimated as 24.6% [95% CI: 16.6–35.5] and 15.1% [95% CI: 8.6–25.7], respectively. For the monotherapies, failure rates were 35.9% [95% CI: 27.0–46.7] for SP and 18.3% [95% CI: 11.6–28.1] for AQ. Out of 207 patients enrolled in Kabalo, the failure rate on day 28 after PCR-genotyping adjustment was 0 [1-sided 95% CI: 5.8] for AS+SP and AS+AQ [1-sided 95% CI: 6.2]. It was 19.6% [95% CI: 11.4–32.7] for SP monotherapy.</p> <p>Conclusion</p> <p>The finding of varying efficacy of the same combinations at two sites in one country highlights one difficulty of implementing a uniform national treatment policy in a large country. The poor efficacy of AS+AQ in Boende should alert the national programme to foci of resistance and emphasizes the need for systems for the prospective monitoring of treatment efficacy at sentinel sites in the country.</p>http://www.malariajournal.com/content/8/1/192 |
| spellingShingle | van Overmeir Chantal Urrutia Pedro van Herp Michel van den Broek Ingrid Bonnet Maryline Kyomuhendo Juliet Ndosimao Célestin Ashley Elizabeth Guthmann Jean-Paul Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies Malaria Journal |
| title | Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies |
| title_full | Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies |
| title_fullStr | Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies |
| title_full_unstemmed | Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies |
| title_short | Varying efficacy of artesunate+amodiaquine and artesunate+sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies |
| title_sort | varying efficacy of artesunate amodiaquine and artesunate sulphadoxine pyrimethamine for the treatment of uncomplicated falciparum malaria in the democratic republic of congo a report of two in vivo studies |
| url | http://www.malariajournal.com/content/8/1/192 |
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