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

MARTHA M. LEMNGE 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

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ABDULLAH S. ALI 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

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EZEKIEL K. MALECELA 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

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EDWARD SAMBU 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

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RAHMA ABDULLA 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

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MOHAMED S. JUMA 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

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KHATIBU FAKIH 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

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KHAFIDH H. ABDULLA 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

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RITHA J. NJAU 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

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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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