1921
Volume 76, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

We compared two dose forms of artemisinin derivatives, dihydroartemisinin suppository (DHA) and intramuscular artemether (ART), in children 6 months to 10 years of age with moderately severe malaria for which oral therapy was not appropriate. Children were randomly allocated to receive three daily doses of DHA or ART followed by a single oral dose of sulfadoxine-pyrimethamine on the third day of both treatment regimens and were monitored for parasitologic and clinical response for 14 days. At enrollment, parasite density was 1,640–523,333/μL (geometric mean parasite density [GMPD] = 58,129/μL) in patients treated with DHA, whereas that for children who received ART was 1,440–559,400/μL (GMPD = 60,387/μL). Mean parasite and fever clearance times were similar in both groups. Days 14 and 28 parasitologic cure rates were 100% (34 of 34) and 96.2% (25 of 26) versus 96.2% (25 of 26) and 91.7% (22 of 24) for children treated with DHA and ART, respectively. In conclusion, both treatment regimens were efficacious and well tolerated.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2007.76.1
2007-01-01
2017-11-20
Loading full text...

Full text loading...

/deliver/fulltext/14761645/76/1/0760001.html?itemId=/content/journals/10.4269/ajtmh.2007.76.1&mimeType=html&fmt=ahah

References

  1. World Health Organization, 2000. Severe and complicated malaria. Trans R Soc Trop Med Hyg 94 (Suppl 1): S1/1–S1-90.
  2. Trape JF, 2001. The public health impact of chloroquine resistance in Africa. Am J Trop Med Hyg 65 : 12–17.
  3. Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI, 2005. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 434 : 214–217.
  4. Greenwood BM, Bradley AK, Greenwood AM, Byass P, Jammeh K, Marsh K, Tulloch S, Oldfield FSJ, Hayes R, 1987. Mortality and morbidity from malaria among children in a rural area of the Gambia, West Africa. Trans R Soc Trop Med Hyg 81 : 478.
  5. Greenberg AE, Ntumbanzando M, Ntula N, Mawa C, Howell J, Davadi F, 1989. Hospital based surveillance of malaria related paediatric morbidity and mortality in Kinshasa, Zaire. Bulletin of the WHO 67 : 186–196.
  6. Marsh K, Forster D, Wariuru C, Mwangi I, Winstanley M, Marsh V, Newton C, Winstanley P, Warn P, Peshu N, Pasvol G, Snow R, 1995. Indicators of life threathening malaria in African children. N Engl J Med 332 : 1399–1404.
  7. Pagnoni F, Convelbo N, Tiendrebeogo J, Cousens S, Esposito F, 1997. A community-based programme to provide prompt and adequate treatment of presumptive malaria in children. Trans R Soc Trop Med Hyg 91 : 512–517.
  8. Aghaji MN, 2002. Injection practices in Enugu, Nigeria. J Col Med 59 : 118–120.
  9. Salako LA, Walker O, Sowunmi A, 1994. Parenteral therapy for severe malaria: comparison of intramuscular artemether and intramuscular sulfadoxine-pyrimethamine. Trans R Soc Top Med Hyg 88 : 89–91.
  10. Arnold K, Hien TT, Chin NT, Phu NH, Mai PP, 1990. A randomized comparative study of artemisinin (ginghaosu) suppositories and oral quinine in acute falciparum malaria. Trans R Soc Trop Med Hyg 84 : 499–502.
  11. Esamai F, Ayuo P, Owino-Ongor W, Rotich J, Ngindu A, Obala A, Ogaro F, Quaqiao L, Xingbo G, Guangqian L, 2000. Rectal dihydroartemisinin versus intravenous quinine in the treatment of severe malaria: a randomizes clinical trial. E African Med J 77 : 273–278.
  12. Tjitra E, Suprianto S, Currie BJ, Morris PS, Saunders JR, Anstey NM, 2001. Therapy of uncomplicated malaria: A randomized trial comparing Artesunate plus sulfadoxine-pyrimethamine versus sulfadoxine-pyrimethamine alone in Irian Jaya, Indonasia. Am J Trop Med Hyg 65 : 309–317.
  13. Awad MI, Alkadru AMY, Behrens RH, Baraka OZ, Eltayeb IB, 2003. Descriptive study on the efficacy and safety of artesunate suppository in combination with other antimalarials in the treatment of severe malaria in Sudan. Am J Trop Med Hyg 68 : 153–158.
  14. Warrel DA, Molyneux ME, Beales PF, 1990. Severe and complicated malaria. Trans R Soc Trop Med Hyg 84 : 1–65.
  15. World Health Organization, 1996. Assessment of Therapeutic Efficacy of Antimalarial Drugs for Uncomplicated Falciparum Malaria in Areas With Intense Transmission. Geneva: World Health Organization.
  16. World Health Organization, 2003. Assessment and Monitoring of Antimalarial Drug Efficacy for the Treatment of Uncomplicated Falciparum Malaria. Geneva: World Health Organization/HIV, Tuberculosis and Malaria (HTM)/Roll Back Malaria (RBM)/.
  17. Happi TC, Thomas SM, Gbotosho GO, Falade CO, Akinboye DO, Gerena L, Hudson T, Sowunmi A, Kyle DE, Milhous W, Wirth DF, Oduola AM, 2003. Point mutations in the pfcrt and pfmdr-1 genes of Plasmodium falciparum and clinical response to chloroquine, among malaria patients from Nigeria. Ann Trop Med Parasitol 97 : 439–451.
  18. Happi CT, Gbotosho GO, Sowunmi A, Falade CO, Akinboye DO, Hudson T, Gerena L, Kyle DE, Milhous W, Wirth DF, Oduola AMJ, 2004. Molecular analysis of Plasmodium falciparum recrudescent malaria infections in children treated with chloroquine in Nigeria. Am J Trop Med Hyg 70 : 20–26.
  19. Sowunmi A, Oduola AMJ, 1996. Efficacy of artemether in severe falciparum malaria in African children. Acta Trop 61 : 57–63.
  20. Hien TT, White NJ, 1993. Quinghaosu. Lancet 341 : 603–608.
  21. Barnes KI, Mwenechanaya J, Tembo M, Folb PI, Ribiero I, Gomes M, Little F, Molyueux ME, 2004. Efficacy of rectal artesunate compared with parenteral quinine in initial treatment of moderately severe malaria in African children and adults. Lancet 363 : 1598–1605.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2007.76.1
Loading
/content/journals/10.4269/ajtmh.2007.76.1
Loading

Data & Media loading...

  • Received : 30 Nov 2005
  • Accepted : 25 Jul 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error