EFFICACY OF CHLOROQUINE, AMODIAQUINE, SULFADOXINE-PYRIMETHAMINE, CHLOROQUINE-SULFADOXINE-PYRIMETHAMINE COMBINATION, AND AMODIAQUINE-SULFADOXINE-PYRIMETHAMINE COMBINATION IN CENTRAL AFRICAN CHILDREN WITH NONCOMPLICATED MALARIA

DIDIER MENARD Pasteur Institute of Bangui, Bangui, Central African Republic; National Malaria Control Program, Central African Republic Ministry of Health, Bangui, Central African Republic

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NESTOR MADJI Pasteur Institute of Bangui, Bangui, Central African Republic; National Malaria Control Program, Central African Republic Ministry of Health, Bangui, Central African Republic

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ALEXANDRE MANIRAKIZA Pasteur Institute of Bangui, Bangui, Central African Republic; National Malaria Control Program, Central African Republic Ministry of Health, Bangui, Central African Republic

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DJIBRINE DJALLE Pasteur Institute of Bangui, Bangui, Central African Republic; National Malaria Control Program, Central African Republic Ministry of Health, Bangui, Central African Republic

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MAX ROGER KOULA Pasteur Institute of Bangui, Bangui, Central African Republic; National Malaria Control Program, Central African Republic Ministry of Health, Bangui, Central African Republic

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ANTOINE TALARMIN Pasteur Institute of Bangui, Bangui, Central African Republic; National Malaria Control Program, Central African Republic Ministry of Health, Bangui, Central African Republic

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This paper reports a two-phase study in Bangui, Central African Republic (CAR): first, we assessed the clinical efficacy to chloroquine (CQ), sulfadoxine-pyrimethamine (SP), and amodiaquine (AQ), then we tested the efficacy of two combinations: CQ + SP and AQ + SP. We used the standard 14-day WHO 2001 protocol to compare therapeutic responses in children under 5 years of age with acute uncomplicated Plasmodium falciparum malaria in Bangui between February 2002 and March 2004. The overall treatment failure rates with CQ, AQ, SP, CQ + SP, and AQ + SP were 40.9%, 20.0%, 22.8%, 7.2%, and 0%. These findings suggest that the Ministry of Health should recommend an interim policy with AQ + SP combination as the first-line antimalarial drug in Bangui until best alternative treatments like artemisinin-based combination therapies (ACTs) become available at low prices in the CAR.

Author Notes

Reprint requests: Didier Menard, Ambassade de France en RCA, Institut Pasteur de Bangui, 128 bis rue de l’université, 75351 Paris 07 SP, Telephone: 00 236 61 86 84, Fax: 00 236 61 01 09, E-mail: dmenard@pasteur-bangui.org, didier.menard@laposte.net.
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