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-
1
World Health Organization, Position of WHO’s Roll Back Malaria Department on malaria treatment policy. http://www.emro.who.int/rbm.
-
2
Korenromp EL, Williams BG, Gouws E, Dye C, Snow RW, 2003. Measurement of trends in childhood malaria mortality in Africa: an assessment of progress toward targets based on verbal autopsy. Lancet Infect Dis 3 :349–358.
-
3
Trape JF, 2001. The public health impact of chloroquine resistance in Africa. Am J Trop Med Hyg 64 :12–17.
-
4
Dorsey G, Njama D, Kamya MR, Cattamanchi A, Kyabayinze D, Staedke SG, Gasasira A, Rosenthal PJ, 2002. Sulfadoxine/pyrimethamine alone or with amodiaquine or artesunate for treatment of uncomplicated malaria: a longitudinal randomised trial. Lancet 360 :2031–2038.
-
5
Gasasira AF, Dorsey G, Nzarubara B, Staedke SG, Nassali A, Rosenthal PJ, Kamya MR, 2003. Comparative efficacy of aminoquinoline-antifolate combinations for the treatment of uncomplicated falciparum malaria in Kampala, Uganda. Am J Trop Med Hyg 68 :127–132.
-
6
Staedke SG, Kamya MR, Dorsey G, Gasasira A, Ndeezi G, Charlebois ED, Rosenthal PJ, 2001. Amodiaquine, sulfadoxine/pyrimethamine, and combination therapy for treatment of uncomplicated falciparum malaria in Kampala, Uganda: a randomised trial. Lancet 358 :368–374.
-
7
Attaran A, Barnes KI, Curtis C, d’Alessandro U, Fanello CI, Galinski MR, Kokwaro G, Looareesuwan S, Makanga M, Mutabingwa TK, Talisuna A, Francois Trape J, Watkins WM, 2004. WHO, the Global Fund, and medical malpractice in malaria treatment. Lancet 363 :237–240.
-
8
Kamya MR, Bakyaita NN, Talisuna AO, Were WM, Staedke SG, 2002. Increasing antimalarial drug resistance in Uganda and revision of the national drug policy. Trop Med Int Health 7 :1031–1041.
-
9
Monitoring antimalarial drug resistance within National Malaria Control Programmes: the EANMAT experience. Trop Med Int Health 6 :891–898.
-
10
World Health Organization, 2003. Assessment and monitoring of antimalarial drug efficacy for the treatment of uncomplicated falciparum malaria. Geneva: World Health Organization technical document. WHO/HTM/RBM/2003.50.
-
11
World Health Organization, 1996. Assessment of therapeutic efficacy of antimalarial drugs for uncomplicated falciparum malaria in areas with intense transmission. Geneva: World Health Organization technical document. WHO/MAL/96.1077.
-
12
Cattamanchi A, Kyabayinze D, Hubbard A, Rosenthal PJ, Dorsey G, 2003. Distinguishing recrudescence from reinfection in a longitudinal antimalarial drug efficacy study: comparison of results based on genotyping of msp-1, msp-2, and glurp. Am J Trop Med Hyg 68 :133–139.
-
13
White N, 2002. The assessment of antimalarial drug efficacy. Trends Parasitol 18 :458–464.
-
14
Phillips-Howard PA, West LJ, 1990. Serious adverse drug reactions to pyrimethamine-sulphadoxine, pyrimethamine-dapsone and to amodiaquine in Britain. J R Soc Med 83 :82–85.
-
15
Snow RW, Eckert E, Teklehaimanot A, 2003. Estimating the needs for artesunate-based combination therapy for malaria case-management in Africa. Trends Parasitol 19 :363–369.
-
16
Rwagacondo CE, Niyitegeka F, Sarushi J, Karema C, Mugisha V, Dujardin JC, Van Overmeir C, van den Ende J, D’Alessandro U, 2003. Efficacy of amodiaquine alone and combined with sulfadoxine-pyrimethamine and of sulfadoxine pyrimethamine combined with artesunate. Am J Trop Med Hyg 68 :743–747.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 19 | 19 | 4 |
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SULFADOXINE-PYRIMETHAMINE PLUS CHLOROQUINE OR AMODIAQUINE FOR UNCOMPLICATED FALCIPARUM MALARIA: A RANDOMIZED, MULTISITE TRIAL TO GUIDE NATIONAL POLICY IN UGANDA
NATHAN BAKYAITA
NATHAN BAKYAITA
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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GRANT DORSEY
GRANT DORSEY
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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ADOKE YEKA
ADOKE YEKA
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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KRISTIN BANEK
KRISTIN BANEK
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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SARAH G. STAEDKE
SARAH G. STAEDKE
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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MOSES R. KAMYA
MOSES R. KAMYA
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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AMBROSE TALISUNA
AMBROSE TALISUNA
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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FRED KIRONDE
FRED KIRONDE
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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SAM NSOBYA
SAM NSOBYA
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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ALBERT KILIAN
ALBERT KILIAN
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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ARTHUR REINGOLD
ARTHUR REINGOLD
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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PHILIP J. ROSENTHAL
PHILIP J. ROSENTHAL
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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FRED WABWIRE-MANGEN
FRED WABWIRE-MANGEN
Ministry of Health, Kampala, Uganda; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Makerere University Medical School, Kampala, Uganda; Division of Epidemiology, School of Public Health, University of California, Berkeley, California; Institute of Public Health, Makerere University, Kampala, Uganda
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The use of combinations of inexpensive drugs for the treatment of malaria in Africa has been proposed as an interim policy while awaiting the widespread availability of more effective regimens. We compared sulfadoxine-pyrimethamine plus chloroquine or amodiaquine in three districts in Uganda. Patients aged 6 months or greater with uncomplicated falciparum malaria were enrolled and randomized to therapy. Safety, tolerability, and efficacy outcomes, adjusted by genotyping, were assessed over 28 days. Of 1,105 patients enrolled, 1,057 (96%) completed follow-up. For children less than 5 years old, the risk of clinical treatment failure adjusted by genotyping at the three sites ranged from 34% to 67% with chloroquine plus sulfadoxine-pyrimethamine and from 13% to 35% with amodiaquine plus sulfadoxine-pyrimethamine (risk differences 21–32%, P < 0.0001 at all sites). Serious adverse events were uncommon with both regimens. The risk of treatment failure with chloroquine plus sulfadoxine-pyrimethamine, the current standard in Uganda, was unacceptably high. Amodiaquine plus sulfadoxine-pyrimethamine was significantly more efficacious; however, existing levels of resistance raises concern about the useful therapeutic life-span of this regimen.
Author Notes
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RefWorks
Reference Manager
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EndNote
-
1
World Health Organization, Position of WHO’s Roll Back Malaria Department on malaria treatment policy. http://www.emro.who.int/rbm.
-
2
Korenromp EL, Williams BG, Gouws E, Dye C, Snow RW, 2003. Measurement of trends in childhood malaria mortality in Africa: an assessment of progress toward targets based on verbal autopsy. Lancet Infect Dis 3 :349–358.
-
3
Trape JF, 2001. The public health impact of chloroquine resistance in Africa. Am J Trop Med Hyg 64 :12–17.
-
4
Dorsey G, Njama D, Kamya MR, Cattamanchi A, Kyabayinze D, Staedke SG, Gasasira A, Rosenthal PJ, 2002. Sulfadoxine/pyrimethamine alone or with amodiaquine or artesunate for treatment of uncomplicated malaria: a longitudinal randomised trial. Lancet 360 :2031–2038.
-
5
Gasasira AF, Dorsey G, Nzarubara B, Staedke SG, Nassali A, Rosenthal PJ, Kamya MR, 2003. Comparative efficacy of aminoquinoline-antifolate combinations for the treatment of uncomplicated falciparum malaria in Kampala, Uganda. Am J Trop Med Hyg 68 :127–132.
-
6
Staedke SG, Kamya MR, Dorsey G, Gasasira A, Ndeezi G, Charlebois ED, Rosenthal PJ, 2001. Amodiaquine, sulfadoxine/pyrimethamine, and combination therapy for treatment of uncomplicated falciparum malaria in Kampala, Uganda: a randomised trial. Lancet 358 :368–374.
-
7
Attaran A, Barnes KI, Curtis C, d’Alessandro U, Fanello CI, Galinski MR, Kokwaro G, Looareesuwan S, Makanga M, Mutabingwa TK, Talisuna A, Francois Trape J, Watkins WM, 2004. WHO, the Global Fund, and medical malpractice in malaria treatment. Lancet 363 :237–240.
-
8
Kamya MR, Bakyaita NN, Talisuna AO, Were WM, Staedke SG, 2002. Increasing antimalarial drug resistance in Uganda and revision of the national drug policy. Trop Med Int Health 7 :1031–1041.
-
9
Monitoring antimalarial drug resistance within National Malaria Control Programmes: the EANMAT experience. Trop Med Int Health 6 :891–898.
-
10
World Health Organization, 2003. Assessment and monitoring of antimalarial drug efficacy for the treatment of uncomplicated falciparum malaria. Geneva: World Health Organization technical document. WHO/HTM/RBM/2003.50.
-
11
World Health Organization, 1996. Assessment of therapeutic efficacy of antimalarial drugs for uncomplicated falciparum malaria in areas with intense transmission. Geneva: World Health Organization technical document. WHO/MAL/96.1077.
-
12
Cattamanchi A, Kyabayinze D, Hubbard A, Rosenthal PJ, Dorsey G, 2003. Distinguishing recrudescence from reinfection in a longitudinal antimalarial drug efficacy study: comparison of results based on genotyping of msp-1, msp-2, and glurp. Am J Trop Med Hyg 68 :133–139.
-
13
White N, 2002. The assessment of antimalarial drug efficacy. Trends Parasitol 18 :458–464.
-
14
Phillips-Howard PA, West LJ, 1990. Serious adverse drug reactions to pyrimethamine-sulphadoxine, pyrimethamine-dapsone and to amodiaquine in Britain. J R Soc Med 83 :82–85.
-
15
Snow RW, Eckert E, Teklehaimanot A, 2003. Estimating the needs for artesunate-based combination therapy for malaria case-management in Africa. Trends Parasitol 19 :363–369.
-
16
Rwagacondo CE, Niyitegeka F, Sarushi J, Karema C, Mugisha V, Dujardin JC, Van Overmeir C, van den Ende J, D’Alessandro U, 2003. Efficacy of amodiaquine alone and combined with sulfadoxine-pyrimethamine and of sulfadoxine pyrimethamine combined with artesunate. Am J Trop Med Hyg 68 :743–747.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 19 | 19 | 4 |
| Full Text Views | 278 | 89 | 0 |
| PDF Downloads | 45 | 15 | 0 |