| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Resistance to chloroquine (CQ) requires its replacement as first-line therapy for uncomplicated malaria in much of Africa. Combination therapy may improve efficacy and delay the selection of resistant malaria parasites. Combinations of sulfadoxine-pyrimethamine (SP) with 4-aminoquinolines offer affordable and available alternatives to CQ. We conducted a randomized, single-blinded trial to compare the efficacy of SP monotherapy with combinations of SP and either CQ or amodiaquine (AQ) for the treatment of uncomplicated falciparum malaria in patients over 6 months of age in Kampala, Uganda. Of the 448 patients enrolled, 428 (95%) completed follow-up. Clinical treatment failure after 14 days occurred in 21/140 (15.0%, 95% CI 9.5–22.0%) SP-treated, 11/152 (7.2%, 95% CI 3.7–12.6%) SP/CQ-treated, and 0/136 (0%, 95% CI 0–2.7%) SP/AQ-treated patients. Combination therapies were safe and offered superior efficacy to SP monotherapy. SP/AQ was the most efficacious. This low-cost combination regimen may provide an optimal alternative to CQ for the treatment of uncomplicated malaria in Uganda.
Received July 8, 2002. Accepted for publication October 17, 2002.
Acknowledgments: We thank study team members Denise Njama, Pauline Byakika, Hakim Sendagire, Sr., B.M. Karakire, Sam Nsobya, Moses Kiggundu, Regina Nakafeero, Christopher Bongole, Mary Kasango, Marx Dongo, Assay Balita, Sara Kibirango, and Annette Birabwa, and all patients who participated in the study.
Financial support: UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) (RCS/T16/181/ 380 ID No. 970655), the Fogarty International Center/National Institutes of Health (TW00007, TW01506, and AI43301), and the Multilateral Initiative on Malaria.
Authors’ addresses: Anne F. Gasasira, Bridget Nzarubara, Annette Nassali and Moses R. Kamya, Makerere University Medical School, P.O. Box 7051, Kampala, Uganda. Grant Dorsey, Sarah G. Staedke and Philip J. Rosenthal, Department of Medicine, P.O. Box 0811, University of California, San Francisco, CA 94143.
Reprint requests: Philip J Rosenthal, Box 0811, University of California, San Francisco, 94143, E-mail: rosnthl{at}itsa.ucsf.edu
This article has been cited by other articles:
|
|
 |
|
  A. Sowunmi, G. O. Gbotosho, C. T. Happi, A. A. Adedeji, F. A. Fehintola, O. A. Folarin, E. Tambo, and B. A. Fateye Therapeutic Efficacy and Effects of Artemether-Lumefantrine and Amodiaquine-Sulfalene-Pyrimethamine on Gametocyte Carriage in Children with Uncomplicated Plasmodium falciparum Malaria in Southwestern Nigeria Am J Trop Med Hyg, August 1, 2007; 77(2): 235 - 241. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Daily Antimalarial drug therapy: the role of parasite biology and drug resistance. J. Clin. Pharmacol., December 1, 2006; 46(12): 1487 - 1497. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. MENDEZ, A. MUNOZ, and C. V. PLOWE Use of area under the curve to characterize transmission potential after antimalarial treatment. Am J Trop Med Hyg, October 1, 2006; 75(4): 640 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. MESHNICK and A. P. ALKER AMODIAQUINE AND COMBINATION CHEMOTHERAPY FOR MALARIA Am J Trop Med Hyg, November 1, 2005; 73(5): 821 - 823. [Full Text] [PDF]
|
|
|
|
|
|
I. ZONGO, G. DORSEY, N. ROUAMBA, C. DOKOMAJILAR, M. LANKOANDE, J.-B. OUEDRAOGO, and P. J. ROSENTHAL AMODIAQUINE, SULFADOXINE-PYRIMETHAMINE, AND COMBINATION THERAPY FOR UNCOMPLICATED FALCIPARUM MALARIA: A RANDOMIZED CONTROLLED TRIAL FROM BURKINA FASO Am J Trop Med Hyg, November 1, 2005; 73(5): 826 - 832. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. BAKYAITA, G. DORSEY, A. YEKA, K. BANEK, S. G. STAEDKE, M. R. KAMYA, A. TALISUNA, F. KIRONDE, S. NSOBYA, A. KILIAN, et al. SULFADOXINE-PYRIMETHAMINE PLUS CHLOROQUINE OR AMODIAQUINE FOR UNCOMPLICATED FALCIPARUM MALARIA: A RANDOMIZED, MULTISITE TRIAL TO GUIDE NATIONAL POLICY IN UGANDA Am J Trop Med Hyg, May 1, 2005; 72(5): 573 - 580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. MENARD, N. MADJI, A. MANIRAKIZA, D. DJALLE, M. R. KOULA, and A. TALARMIN EFFICACY OF CHLOROQUINE, AMODIAQUINE, SULFADOXINE-PYRIMETHAMINE, CHLOROQUINE-SULFADOXINE-PYRIMETHAMINE COMBINATION, AND AMODIAQUINE-SULFADOXINE-PYRIMETHAMINE COMBINATION IN CENTRAL AFRICAN CHILDREN WITH NONCOMPLICATED MALARIA Am J Trop Med Hyg, May 1, 2005; 72(5): 581 - 585. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. L. PITMANG, T. D. THACHER, J. K. A. MADAKI, D. Z. EGAH, and P. R. FISCHER COMPARISON OF SULFADOXINE-PYRIMETHAMINE WITH AND WITHOUT CHLOROQUINE FOR UNCOMPLICATED MALARIA IN NIGERIA Am J Trop Med Hyg, March 1, 2005; 72(3): 263 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Gregson and C. V. Plowe Mechanisms of Resistance of Malaria Parasites to Antifolates Pharmacol. Rev., March 1, 2005; 57(1): 117 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Bell and P. Winstanley Current issues in the treatment of uncomplicated malaria in Africa Br. Med. Bull., December 13, 2004; 71(1): 29 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. DORSEY, A. F. GASASIRA, R. MACHEKANO, M. R. KAMYA, S. G. STAEDKE, and A. HUBBARD THE IMPACT OF AGE, TEMPERATURE, AND PARASITE DENSITY ON TREATMENT OUTCOMES FROM ANTIMALARIAL CLINICAL TRIALS IN KAMPALA, UGANDA Am J Trop Med Hyg, November 1, 2004; 71(5): 531 - 536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. VREUGDENHIL, F. Y. SCHEPER, S. R. HOOGSTRAATTE, M. SMOLDERS, S. GIKUNDA, F. G. COBELENS, and P. A. KAGER COMPARISON OF THE PARASITOLOGIC EFFICACY OF AMODIAQUINE AND SULFADOXINE-PYRIMETHAMINE IN THE TREATMENT OF PLASMODIUM FALCIPARUM MALARIA IN THE BUNGOMA DISTRICT OF WESTERN KENYA Am J Trop Med Hyg, November 1, 2004; 71(5): 537 - 541. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. BLOLAND A CONTRARIAN VIEW OF MALARIA THERAPY POLICY IN AFRICA Am J Trop Med Hyg, February 1, 2003; 68(2): 125 - 126. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
