In-vivo efficacy of amodiaquine-artesunate in children with uncomplicated Plasmodium falciparum malaria in western Kenya
To assess the efficacy of amodiaquine-artesunate in an area with high chloroquine resistance in western Kenya. Twenty-eight day in-vivo efficacy trial of amodiaquine-artesunate in 103 children aged 6-59 months in western Kenya with smear-confirmed uncomplicated Plasmodium falciparum malaria. The 28-...
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Published in: | Tropical medicine & international health Vol. 14; no. 3; pp. 294 - 300 |
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Main Authors: | , , , , , , , , , , , , |
Format: | Journal Article |
Language: | English |
Published: |
Oxford, UK
Oxford, UK : Blackwell Publishing Ltd
01-03-2009
Blackwell Publishing Ltd Blackwell |
Subjects: | |
Online Access: | Get full text |
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Summary: | To assess the efficacy of amodiaquine-artesunate in an area with high chloroquine resistance in western Kenya. Twenty-eight day in-vivo efficacy trial of amodiaquine-artesunate in 103 children aged 6-59 months in western Kenya with smear-confirmed uncomplicated Plasmodium falciparum malaria. The 28-day uncorrected adequate clinical and parasitological response (ACPR) was 69.0%, with 15.5% Late Clinical Failure and 15.5% Late Parasitologic Failure rates. The PCR-corrected 28-day ACPR was 90.2%. Clinical risk factors for recurrent infection (recrudescences and reinfections) were lower axillary temperature at enrolment and low weight-for-age Z-score. The presence of single nucleotide polymorphisms pfcrt 76T and pfmdr1 86Y at baseline was associated with increased risk of recurrent infections, both reinfections and recrudescences. Although artemether-lumefantrine (Coartem®) is the first line ACT in Kenya, amodiaquine-artesunate is registered as an option for treatment of uncomplicated P. falciparum and remains an effective alternative to Coartem® in western Kenya. Continued amodiaquine monotherapy in the private sector may jeopardise the future use of amodiaquine-artesunate as an alternative artemisinin-based combination therapy. |
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Bibliography: | http://dx.doi.org/10.1111/j.1365-3156.2009.02222.x ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
ISSN: | 1360-2276 1365-3156 |
DOI: | 10.1111/j.1365-3156.2009.02222.x |