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Comparison of Different Artemisinin-based Combinations for the Treatment of Plasmodium falciparum Malaria in Children in Kigali, Rwanda, an Area of Resistance to Sulfadoxine-Pyrimethamine: Artesunate Plus Sulfadoxine/Pyrimethamine versus Artesunate Plus Sulfamethoxypyrazine/Pyrimethamine

In view of the changing policy towards artemisinin-based combination therapies (ACTs), the efficacy, tolerance, and degree of re-infection of two ACTs were investigated: artesunate plus sulfadoxine/pyrimethamine (As + SP) and AS plus sulfamethoxypyrazine/pyrimethamine (As + SMP). One hundred three children were assigned to receive As + SP and 109 to receive As + SMP. In spite of the high incidence of resistance to SP, As + SP showed satisfactory results consistent with recent recommendations for ACTs (adequate clinical and parasitologic response on day 28 [ACPR] 90%), but results with As + SMP fulfilled the most stringent criteria (ACPR 95%). The absence of side effects and the low price of these drugs make them it worth to reconsider national therapies in favor of either of these two drug combinations.

Received August 23, 2006. Accepted for publication June 24, 2007.

Acknowledgments: We are grateful to all persons who participated in this study, the staff at the three sites for assistance, and Dr. A. Djimdé (Malaria Research and Training Centre, Bamako, Mali), for technical assistance in the analysis of the PCR samples.

Financial support: This study was supported by a grant from Dafra Pharma NV to Stephen Rulisa.

^* Address correspondence to Stephen Rulisa, Central University Hospital of Kigali, BP 655 Kigali, Rwanda. E-mail: stevenruse{at}yahoo.com

Authors’ addresses: Stephen Rulisa, Central University Hospital of Kigali, BP 655 Kigali, Rwanda, E-mail: stevenruse{at}yahoo.com. Jean Philip Gatarayiha, National Institute of Statistics, BP 6139, Kigali, Rwanda, E-mail: gatarayihajp{at}hotmail.com. Tharcisse Kabarisa, Kicukiro Health Center, BP 2308 Kigali, Rwanda. Gill Ndayisaba, Lux Development , BP 3503 Kigali , Rwanda , E-mail : ndayisaba{at}gmail.com.

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