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Am. J. Trop. Med. Hyg., 71(3), 2004, pp. 294-296
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT: LACK OF PREDICTION OF AMODIAQUINE EFFICACY IN TREATING PLASMODIUM FALCIPARUM MALARIA BY IN VITRO TESTS

AGNÉS AUBOUY, JUSTICE MAYOMBO, ANNICK KEUNDJIAN, MOHAMED BAKARY, JACQUES LE BRAS, AND PHILIPPE DELORON
Centre International de Recherches Médicales de Franceville, Unité de Parasitologie Médicale, Franceville, Gabon; Unité de Parasitologie, Institut de Médecine Tropicale du Service de Santé des Armées, le Pharo, Marseille Armées, France; Hôpital de Bakoumba, Bakoumba, Gabon; Hôpital Bichat-Claude Bernard, Laboratoire de Parasitologie, Paris, France; Institut de Recherche pour le Développement, Unité de Recherche 010 Mother and Child Health in the Tropics, Paris, France

 

ABSTRACT

Amodiaquine (AQ) is currently a major candidate for new antimalarial combinations, although in vivo and in vitro tests have been rarely simultaneously investigated. The efficacy of AQ was assessed at the dose of 30 mg/kg in treating Plasmodium falciparum malaria attacks in 74 children from southeast Gabon, and the in vitro activity of monodesethylamodiaquine (MdAQ), the main metabolite of AQ, was measured against P. falciparum parasites isolated from these children. Treatment failures were observed in 40.5% of the children, while 5.4% of the isolates showed in vitro resistance to MdAQ. No relationship was observed between in vivo and in vitro susceptibility. The in vitro activities of MdAQ and chloroquine were correlated. The reasons for such disparities between in vivo and in vitro AQ activities are discussed and the issue of the validity of in vitro tests to measure AQ efficacy is raised.

Received January 23, 2004. Accepted for publication April 9, 2004.

Acknowledgments: We are grateful to the children who participated in the study, as well as to their mothers and guardians. We also thank J. Bourgeais (Le Site de la Société d’Exploitation du Parc de la Lékédi) for logistical support in Bakoumba.

Financial support: This work was supported by the French Ministry of Research (VIHPAL grant) and by the Fondation pour la Recherche Médicale. Agnes Aubouy was the recipient of a fellowship from the French Ministry of Research.

Authors’ addresses: Agnes Aubouy and Philippe Deloron, Faculté de Pharmacie, Institut de Recherche pour le Développement, Unité de Recherche 010, 4 Avenue de l’Observatoire, 75006 Paris, France, Telephone: 33-1-53-73-96-22. Justice Mayombo, Center International de Recherches Médicales de Franceville, BP 769 Franceville, Gabon, Telephone: 241-677-096. Annick Keundjian, Unité de Parasitologie, Institut de Médecine Tropicale du Service de Santé des Armées, le Pharo, BP46, 13998 Marseille Armées, France, Telephone: 33-4-91-50116. Mohamed Bakary, Hôpital de Bakoumba, BP52, Bakoumba, Gabon, Telephone: 241-661-101. Jacques Le Bras, Hôpital Bichat-Claude Bernard, 75877 Paris, France, Telephone: 33-1-40-25-78-99.

Reprint requests: Philippe Deloron, Institut de Recherche pour le Développement, Unité de Recherche 010, Faculté de Pharmacie, 4 Avenue de l’Observatoire, 75006 Paris, France, Telephone: 33-1-53-73-96-22, Fax: 33-1-53-73-96-17, E-mail: Philippe.Deloron{at}ird.fr.




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Copyright © 2004 by the American Society of Tropical Medicine and Hygiene.