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
Main Authors: Thwing, J.I, Odero, C.O, Odhiambo, F.O, Otieno, K.O, Kariuki, S, Ord, R, Roper, C, McMorrow, M, Vulule, J, Slutsker, L, Newman, R.D, Hamel, M.J, Desai, M
Format: Journal Article
Language:English
Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01-03-2009
Blackwell Publishing Ltd
Blackwell
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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.
Bibliography:http://dx.doi.org/10.1111/j.1365-3156.2009.02222.x
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ISSN:1360-2276
1365-3156
DOI:10.1111/j.1365-3156.2009.02222.x