• 1

    Kihamia CM, Gill HS, 1982. Chloroquine-resistant falciparum malaria in semi-immune native African Tanzanians. Lancet ii: 43.

  • 2

    Campbell CC, Payne D, Schwartz IK, Khatib OJ, 1982. Evaluation of amodiaquine treatment of chloroquine-resistant Plasmodium falciparum malaria on Zanzibar, 1982. Am J Trop Med Hyg 32 :1216–1220.

    • Search Google Scholar
    • Export Citation
  • 3

    Irare SG, Lemnge MM, Mhina JK, 1991. Falciparum malaria fully cleared by amodiaquine, pyrimethamine-sulfadoxine and pyrimethamine-sulfalene in areas of chloroquine resistance in Dodoma, Tanzania. Trop Geogr Med 43 :351–356.

    • Search Google Scholar
    • Export Citation
  • 4

    Watkins WM, Sixsmith DG, Spencer HC, Boriga DA, Kariuki DM, Koech DK, 1984. Effectiveness of amodiaquine as treatment for chloroquine-resistant Plasmodium falciparum infections in Kenya. Lancet. 1 :357–359.

    • Search Google Scholar
    • Export Citation
  • 5

    World Health Organisation, 1996. Assessment of therapeutic efficacy of antimalarial drugs for uncomplicated falciparum malaria in areas with intense transmission. Unpublished World Health Organization document, WHO/MAL/96.1077.

  • 6

    Zanzibar Statistical Abstract, 1997. Zanzibar: Department of Statistics, Ministry of State Planning and Investments.

  • 7

    World Health Organization, 2002. Assessment of therapeutic efficacy of antimalarial drugs [draft document]. Geneva: World Health Organization.

  • 8

    World Health Organization, 1973. Chemotherapy of Malaria and Resistance to Antimalarials. Report of a WHO Scientific Working Group. Technical Report Series, No. 529. Geneva: World Health Organization.

  • 9

    Gorissen E, Ashruf G, Lamboo M, Bennebroek J, Gikunda S, Mbaruku G, Kager PA, 2000. In vivo efficacy study of amodiaquine and sulfadoxine/pyrimethamine in Kibwezi, Kenya and Kigoma, Tanzania. Trop Med Int Health 5 :459–463.

    • Search Google Scholar
    • Export Citation
  • 10

    van Dillen J, Custers M, Wensink A, Wouters B, van Voorthuizen T, Khan B, Muller L, Nevill C, 1999. A comparison of amodiaquine and sulfadoxine-pyrimethamine for first-line treatment of falciparum malaria in Kenya. Trans R Soc Trop Med Hyg 93 :185–188.

    • Search Google Scholar
    • Export Citation
  • 11

    Ronn AM, Msangeni HA, Mhina J, Wernsdorfer WH, Bygbjerg IC, 1996. High level of resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine in children in Tanzania. Trans R Soc Trop Med Hyg 90 :179–181.

    • Search Google Scholar
    • Export Citation
  • 12

    Lemnge MM, Msangeni HA, Rønn AM, Salum FM, Jakobsen PH, Mhina JI, Akida JA, Bygbjerg IC, 1997. Maloprim malaria prophylaxis in children living in a holoendemic village in northeastern Tanzania. Trans R Soc Trop Med Hyg 91 :68–73.

    • Search Google Scholar
    • Export Citation
  • 13

    Trigg JK, Mbwana H, Chambo O, Hills E, Watkins WM, Curtis CF, 1997. Resistance to pyrimethamine/sulfadoxine in Plasmodium falciparum in 12 villages in north east Tanzania and a test of chlorproguanil/dapsone. Acta Tropica 63 :185–189.

    • Search Google Scholar
    • Export Citation
  • 14

    Mugittu K, Ndejembi M, Malisa A, Lemnge M, Premji Z, Mwita A, Nkya W, Katarihya J, Abdullah S, Beck HP, Mshinda H, 2004. Therapeutic efficacy of sulfadoxine-pyrimethamine and prevalence of resistance markers in Tanzania prior to revision of malaria treatment policy: Plasmodium falciparum dhfr and dhps mutations in monitoring in vivo resistance. Am J Trop Med Hyg 71 : 696–702,

    • Search Google Scholar
    • Export Citation
  • 15

    Mutabingwa TK, Watkins WM, Nzila-Mounda A, Mberu E, Winstanley P, Nduati E, Hills E, 2001. Drug resistant falciparum malaria in Tanzania: chlorproguanil-dapsone is effective treatment for infections resistant to pyrimethamine-sulfadoxine. Lancet 358 :1218–1223.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

THERAPEUTIC EFFICACY OF SULFADOXINE-PYRIMETHAMINE AND AMODIAQUINE AMONG CHILDREN WITH UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA IN ZANZIBAR, TANZANIA

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  • 1 National Institute for Medical Research, Amani Medical Research Centre, Amani, Tanga, Tanzania; Ministry of Health, Zanzibar Malaria Control Programme, Zanzibar, Tanzania; Kivunge Cottage Hospital, Zanzibar, Tanzania; Chake Chake Hospital, Pemba, Zanzibar, Tanzania; Wete Hospital, Pemba, Zanzibar, Tanzania; Ministry of Health, Malaria Control Unit, Chake Chake, Pemba, Zanzibar, Tanzania; World Health Organization, Country Office, Dar es Salaam, Tanzania

The efficacy of sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) was assessed at Kivunge and Micheweni in Zanzibar, Tanzania, in 2001. The main objective was to obtain baseline data after observations of high levels of chloroquine treatment failures. Children (6–59 months) were randomized to receive either drug. At Kivunge, SP and AQ were given to 64 and 63 cases, while for Micheweni, 61 and 70 cases were treated. Main findings were overall high rates (> 90%) of adequate clinical response (ACR) with AQ. A lower ACR was seen in the SP group at Kivunge (87.1%) compared with Micheweni (94.8%). Furthermore, in the ACR group, 16.7% AQ parasitological resistance (RI–RIII) was encountered at Kivunge. Most of the cases of SP parasitological resistance (14.5%; RI/RII) were seen at Micheweni. Notwithstanding this, the overall treatment failure was only 9.2% with SP and 5.5% with AQ. The Zanzibar Ministry of Health has since reviewed its antimalarial drug policy.

Author Notes

Reprint requests: Martha M. Lemnge, Amani Medical Research Centre, P.O. Box 4, Amani, Tanga, Tanzania, Telephone: 255 27 26 40303, Fax: 255 27 26 43869, E-mail: mlemnge@amani.mimcom.net; mlemnge@hotmail.com.
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