HIGH EFFICACY OF TWO ARTEMISININ-BASED COMBINATIONS (ARTESUNATE + AMODIAQUINE AND ARTEMETHER + LUMEFANTRINE) IN CAALA, CENTRAL ANGOLA

JEAN-PAUL GUTHMANN Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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SANDRA COHUET Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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CHRISTINE RIGUTTO Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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FILOMENO FORTES Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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NILTON SARAIVA Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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JAMES KIGULI Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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JULIET KYOMUHENDO Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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MAX FRANCIS Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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FRÉDÉRIC NOËL Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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MARYLINE MULEMBA Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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SUNA BALKAN Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

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In April 2004, 137 children 6–59 months of age with uncomplicated Plasmodium falciparum (Pf) malaria (Caala, Central Angola) were randomized to receive either artemether-lumefantrine (Coartem) or artesunate + amodiaquine (ASAQ). After 28 days of follow-up, there were 2/61 (3.2%) recurrent parasitemias in the Coartem group and 4/64 (6.2%) in the ASAQ group (P = 0.72), all classified as re-infections after PCR genotyping (cure rate = 100% [95%CI: 94–100] in both groups). Only one patient (ASAQ group) had gametocytes on day 28 versus five (Coartem) and three (ASAQ) at baseline. Compared with baseline, anemia was significantly improved after 28 days of follow-up in both groups (Coartem: from 54.1% to 13.4%; ASAQ: from 53.1% to 15.9%). Our findings are in favor of a high efficacy of both combinations in Caala. Now that Coartem has been chosen as the new first-line anti-malarial, the challenge is to insure that this drug is available and adequately used.

Author Notes

Reprints requests: Jean-Paul Guthmann, Epicentre, 8 rue Saint Sabin, 75011 Paris, France. E-mail: jguthmann@epicentre.msf.org.
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