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Am. J. Trop. Med. Hyg., 79(1), 2008, pp. 42-44
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Surveillance for Adverse Drug Reactions to Combination Antimalarial Therapy with Sulfadoxine-Pyrimethamine plus Artesunate in Peru

Javier Cairo, Salomón Durand, Wilmer Marquiño, César Cabezas, Arnaldo Lachira, Fernando Quintana, Walter Vegas, Trenton K. Ruebush, II, Gregory Utz, AND David J. Bacon*
U.S. Naval Medical Research Center Detachment Lima, Peru; National Institute of Health Lima, Peru; Dirección Regional de Salud Piura, Ministerio de Salud Piura, Peru

 

ABSTRACT

In 2001, Peru changed its treatment policy for uncomplicated Plasmodium falciparum malaria on the northern Pacific Coast to sulfadoxine-pyrimethamine with atresunate (SP-AS). Because Peru was the first country in the Americas to adopt this combination therapy, we established a surveillance system in the region to assess the frequency of new or worsening symptoms after starting therapy. Over a period of two years, 1,552, or approximately two-thirds of all patients with uncomplicated P. falciparum malaria who had received SP-AS on the northern coast were followed up. Of these, 8.8% reported at least one adverse effect, with the most common being vomiting, nausea, headache, abdominal pain, dizziness, and fever; no severe adverse effects related to SP-AS therapy were identified. Treatment of uncomplicated malaria with SP-AS was associated with a low frequency of mild adverse effects in Peru, and therefore should be considered as a first-line therapy in areas of the Americas where SP efficacy is still high.

Received June 26, 2007. Accepted for publication March 17, 2008.

Financial support: This study was supported by the Department of Defense–Global Emerging Infectious System under the unit number 847705.82000.256B,B0016, and by the U.S. Agency for International Development–Government of Peru VIGIA Project addressing Threats of Emerging and Re-Emerging Infectious Diseases (Activity 527-0391).

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy of the Department of the Navy, Department of Defense, nor the U.S. government. Some of the authors are military service members. This work was prepared as part of our official duties. Title 17 U.S.C. §105 provide that "Copyright protection under this title is not available for any work of the United States Government." Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.

* Address correspondence to David J. Bacon, Navy Environmental and Preventative Medicine Unit-2, 1887 Powhatan St., Norfolk, VA 23511-3394. E-mail: david.bacon{at}med.navy.mil

Authors’ addresses: Javier Cairo and Salomón Durand, Naval Medical Research Center Detachment, Unit 3800, APO AA 34031, Tel: 203-751-1615, E-mails: javier.cairolavado{at}yale.edu and salomondurand{at}gmail.com. Wilmer Marquiño, National Institute of Health Lima, Peru. César Cabezas, National Institute of Health Lima, Peru, E-mail: ccabezas{at}ins.gob.pe. Arnaldo Lachira, Fernando Quintana, and Walter Vegas, Dirección Regional de Salud Piura, Ministerio de Salud Piura, Peru, E-mail: alachira{at}yahoo.com. Trenton K. Ruebush II, U.S. Agency for International Development Bureau for Global Health, 1300 Pennsylvania Avenue, NW, Washington, D.C. 20523-4600, E-mail: truebush{at}usaid.gov. Gregory Utz, Infectious Diseases and Internal Medicine, 34800 Bob Wilson Drive, Suite 110 San Diego, CA 92134, E-mail: greg.utz{at}med.navy.mil. David J. Bacon, Navy Environmental and Preventative Medicine Unit-2, 1887 Powhatan St., Norvolk, VA 23511-3394, Tel: 757-953-6571, Fax: 757-953-7212, E-mail: david.bacon{at}med.navy.mil.






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