• 1

    World Health Organization, 2008. World Malaria Report. Geneva: World Health Organization. Available at: http://www.who.int/malaria/wmr2008/malaria2008.pdf. Accessed April 12, 2009.

  • 2

    Campbell CC, 2008. Halting the toll of malaria in Africa. Am J Trop Med Hyg 78 :851–853.

  • 3

    Winstanley P, 2001. Chlorproguanil-dapsone (LAPDAP) for uncomplicated falciparum malaria. Trop Med Int Health 6 :952–954.

  • 4

    Alloueche A, Bailey W, Barton S, Bwika J, Chimpeni P, Falade CO, Fehintola FA, Horton J, Jaffar S, Kanyok T, Kremsner PG, Kublin JG, Lang T, Missinou MA, Mkandala C, Oduola AM, Premji Z, Robertson L, Sowunmi A, Ward SA, Winstanley PA, 2004. Comparison of chlorproguanil–dapsone with sulfadoxine–pyrimethamine for the treatment of uncomplicated falciparum malaria in young African children: double-blind randomised controlled trial. Lancet 363 :1843–1848.

    • Search Google Scholar
    • Export Citation
  • 5

    Price RN, Nosten F, Luxemburger C, van Vugt M, Phaipun L, Chongsuphajaisiddhi T, White NJ, 1997. Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. Trans R Soc Trop Med Hyg 91 :574–577.

    • Search Google Scholar
    • Export Citation
  • 6

    van Vugt M, Looareesuwan S, Wilairatana P, McGready R, Villegas L, Gathmann I, Mull R, Brockman A, White NJ, Nosten F, 2000. Artemether-lumefantrine for the treatment of multidrug-resistant falciparum malaria. Trans R Soc Trop Med Hyg 94 :545–548.

    • Search Google Scholar
    • Export Citation
  • 7

    Alin MH, Bjorkman A, 1994. Concentration and time dependency of artemisinin efficacy against Plasmodium falciparum in vitro. Am J Trop Med Hyg 50 :771–776.

    • Search Google Scholar
    • Export Citation
  • 8

    Angus BJ, Thaiaporn I, Chanthapadith K, Suputtamongkol Y, White NJ, 2002. Oral artesunate dose-response relationship in acute falciparum malaria. Antimicrob Agents Chemother 46 :778–782.

    • Search Google Scholar
    • Export Citation
  • 9

    Dutta GP, Bajpai R, Vishwakarma RA, 1989. Artemisinin (qinghaosu)–a new gametocytocidal drug for malaria. Chemotherapy 35 :200–207.

  • 10

    Barnes KI, Durrheim DN, Little F, Jackson A, Mehta U, Allen E, Dlamini SS, Tsoka J, Bredenkamp B, Mthembu DJ, White NJ, Sharp BL, 2005. Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa. PLoS Med 2 :e330.

    • Search Google Scholar
    • Export Citation
  • 11

    Bousema JT, Schneider P, Gouagna LC, Drakeley CJ, Tostmann A, Houben R, Githure JI, Ord R, Sutherland CJ, Omar SA, Sauerwein RW, 2006. Moderate effect of artemisinin-based combination therapy on transmission of Plasmodium falciparum. J Infect Dis 193 :1151–1159.

    • Search Google Scholar
    • Export Citation
  • 12

    Hallett RL, Sutherland CJ, Alexander N, Ord R, Jawara M, Drakeley CJ, Pinder M, Walraven G, Targett GA, Alloueche A, 2004. Combination therapy counteracts the enhanced transmission of drug-resistant malaria parasites to mosquitoes. Antimicrob Agents Chemother 48 :3940–3943.

    • Search Google Scholar
    • Export Citation
  • 13

    Price RN, Nosten F, Luxemburger C, ter Kuile FO, Paiphun L, Chongsuphajaisiddhi T, White NJ, 1996. Effects of artemisinin derivatives on malaria transmissibility. Lancet 347 :1654–1658.

    • Search Google Scholar
    • Export Citation
  • 14

    World Health Organization, 2006. Guidelines for the Treatment of Malaria. Geneva: World Health Organization. Available at: http://malaria.who.int/docs/TreatmentGuidelines2006.pdf. Accessed August 22, 2008.

  • 15

    Wootton DG, Opara H, Biagini GA, Kanjala MK, Duparc S, Kirby PL, Woessner M, Neate C, Nyirenda M, Blencowe H, Dube-Mbeye Q, Kanyok T, Ward S, Molyneux M, Dunyo S, Winstanley PA, 2008. Open-label comparative clinical study of chlorproguanil-dapsone fixed dose combination (Lapdap) alone or with three different doses of artesunate for uncomplicated Plasmodium falciparum malaria. PLoS One 3 :e1779.

    • Search Google Scholar
    • Export Citation
  • 16

    World Health Organization, 2004. Review of the safety of chlorproguanil-dapsone in the treatment of uncomplicated falciparum malaria in Africa. Report of a Technical Consultation Convened by WHO. Geneva: World Health Organization. Available at: http://www.who.int/malaria/docs/LapDap.pdf. Accessed July 23, 2008.

  • 17

    Beutler E, Duparc S, 2007. Glucose-6-phosphate dehydrogenase deficiency and antimalarial drug development. Am J Trop Med Hyg 77 :779–789.

    • Search Google Scholar
    • Export Citation
  • 18

    Beutler E, Kuhl W, Vives-Corrons JL, Prchal JT, 1989. Molecular heterogeneity of glucose-6-phosphate dehydrogenase A. Blood 74 :2550–2555.

    • Search Google Scholar
    • Export Citation
  • 19

    Premji Z, Umeh R, Owusu-Agyei S, Esamai F, Ezedinachi E, Oguche S, Borrmann S, Sowunmi A, Duparc S, Kirby P, Pamba A, Kellam L, Guiguemdé R, Greenwood B, Ward S, Winstanley P, 2009. Chlorproguanil-dapsone-artesunate versus artemether–lumefantrine: a randomized, double-blind phase III trial in African children and adolescents with uncomplicated Plasmodium falciparum malaria. PLoS One 4 :e6682.

    • Search Google Scholar
    • Export Citation
  • 20

    World Health Organization, 2003. Assessment and Monitoring of Antimalarial Drug Efficacy for the Treatment of Uncomplicated Falciparum Malaria. (WHO/HTM/RBM/2003.50). Geneva: World Health Organization. Available at: http://www.who.int/malaria/docs/ProtocolWHO.pdf. Accessed July 6, 2008.

  • 21

    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.

    • Search Google Scholar
    • Export Citation
  • 22

    Medicines for Malaria Venture, World Health Organization, 2008. Methods and Techniques for Clinical Trials on Anti-Malarial Drug Efficacy: Genotyping to Identify Parasite Populations. Geneva: World Health Organization. Available at: http://www.who.int/malaria/docs/drugresistance/MalariaGenotyping.pdf. Accessed July 25, 2008.

  • 23

    Nafa K, Reghis A, Osmani N, Baghli L, Ait-Abbes H, Benabadji M, Kaplan JC, Vulliamy T, Luzzatto L, 1994. At least five polymorphic mutants account for the prevalence of glucose-6-phosphate dehydrogenase deficiency in Algeria. Hum Genet 94 :513–517.

    • Search Google Scholar
    • Export Citation
  • 24

    Poggi V, Town M, Foulkes NS, Luzzatto L, 1990. Identification of a single base change in a new human mutant glucose-6-phosphate dehydrogenase gene by polymerase-chain-reaction amplification of the entire coding region from genomic DNA. Biochem J 271 :157–160.

    • Search Google Scholar
    • Export Citation
  • 25

    Samilchuk E, D’Souza B, Al-Awadi S, 1999. Population study of common glucose-6-phosphate dehydrogenase mutations in Kuwait. Hum Hered 49 :41–44.

    • Search Google Scholar
    • Export Citation
  • 26

    Krudsood S, Imwong M, Wilairatana P, Pukrittayakamee S, Nonprasert A, Snounou G, White NJ, Looareesuwan S, 2005. Artesunate-dapsone-proguanil treatment of falciparum malaria: genotypic determinants of therapeutic response. Trans R Soc Trop Med Hyg 99 :142–149.

    • Search Google Scholar
    • Export Citation
  • 27

    Lynch C, Pearce R, Pota H, Cox J, Abeku TA, Rwakimari J, Naidoo I, Tibenderana J, Roper C, 2008. Emergence of a dhfr mutation conferring high-level drug resistance in Plasmodium falciparum populations from southwest Uganda. J Infect Dis 197 :1598–1604.

    • Search Google Scholar
    • Export Citation
  • 28

    Hamel MJ, Poe A, Bloland P, McCollum A, Zhou Z, Shi YP, Ouma P, Otieno K, Vulule J, Escalante A, Udhayakumar V, Slutsker L, 2008. Dihydrofolate reductase I164L mutations in Plasmodium falciparum isolates: clinical outcome of 14 Kenyan adults infected with parasites harbouring the I164L mutation. Trans R Soc Trop Med Hyg 102 :338–345.

    • Search Google Scholar
    • Export Citation
  • 29

    Fanello CI, Karema C, Ngamije D, Uwimana A, Ndahindwa V, Van Overmeir C, Van Doren W, Curtis J, D’Alessandro U, 2008. A randomised trial to assess the efficacy and safety of chlorproguanil/dapsone + artesunate for the treatment of uncomplicated Plasmodium falciparum malaria. Trans R Soc Trop Med Hyg 102 :412–420.

    • Search Google Scholar
    • Export Citation
  • 30

    Owusu-Agyei S, Asante KP, Owusu R, Adjuik M, Amenga-Etego S, Dosoo DK, Gyapong J, Greenwood B, Chandramohan D, 2008. An open label, randomised trial of artesunate + amodiaquine, artesunate + chlorproguanil-dapsone and artemetherlumefantrine for the treatment of uncomplicated malaria. PLoS One 3 :e2530.

    • Search Google Scholar
    • Export Citation
  • 31

    Simpson JA, Hughes D, Manyando C, Bojang K, Aarons L, Winstanley P, Edwards G, Watkins WA, Ward S, 2006. Population pharmacokinetic and pharmacodynamic modelling of the antimalarial chemotherapy chlorproguanil/dapsone. Br J Clin Pharmacol 61 :289–300.

    • Search Google Scholar
    • Export Citation
  • 32

    Fanello CI, Karema C, Avellino P, Bancone G, Uwimana A, Lee SJ, d’Alessandro U, Modiano D, 2008. High risk of severe anaemia after chlorproguanildapsone + artesunate antimalarial treatment in patients with G6PD (A-) deficiency. PLoS One 3 :e4031.

    • Search Google Scholar
    • Export Citation
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Chlorproguanil–Dapsone–Artesunate versus Chlorproguanil–Dapsone: A Randomized, Double-Blind, Phase III Trial in African Children, Adolescents, and Adults with Uncomplicated Plasmodium falciparum Malaria

Alfred B. TionoCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Alassane DickoCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Dennis A. NdububaCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Tsiri AgbenyegaCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Simon PitmangCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Jacob AwobusuyiCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Allan PambaCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Stephan DuparcCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Li-Ean GohCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Emma HarrellCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Nick CarterCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Stephen A. WardCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Brian GreenwoodCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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Peter A. WinstanleyCentre National de Recherche et de Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Malaria Research and Training Centre and Department of Public Health, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali; Obafemi Awolowo University Teaching Hospital, Department of Medicine, Ile Ife, Nigeria; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Medicine, Plateau State Specialist Hospital, Jos, Plateau State, Nigeria; Lagos State University Teaching Hospital, Department of Medicine, Ikeja, Lagos, Nigeria; GlaxoSmithKline, Greenford, Middlesex, United Kingdom; GlaxoSmithKline, Harlow, Essex; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; School of Clinical Sciences, University of Liverpool, Liverpool, United Kingdom

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This multi-center, randomized, parallel-group, double-blind, double-dummy study compared the efficacy and safety of chlorproguanil–dapsone–artesunate (CDA) and chlorproguanil–dapsone (CPG–DDS) in the treatment of falciparum malaria in Africa (Burkina Faso, Ghana, Mali, Nigeria). Six hundred patients (≥ 1 year of age) received CDA 2.0/2.5/4.0 mg/kg, and 292 CPG–DDS 2.0/2.5 mg/kg, once daily for 3 days. Day 28 parasitologic cure rate (polymerase chain reaction [PCR]-corrected, per-protocol population) was 89.1% (416/467) for CDA, non-inferior but also superior to CPG–DDS, 83.0% (176/212) (treatment difference 6.1%; 95% confidence interval [CI] 0.3, 11.9). Glucose-6-phosphate dehydrogenase (G6PD) genotype was available for 844/892 (95%) patients. Occurrences of a composite hemoglobin safety endpoint (hemoglobin drop ≥ 40 g/L or ≥ 40% versus baseline, hemoglobin < 50 g/L, or blood transfusion) were CDA 13/44 (30%), CPG–DDS 7/24 (29%) in G6PD-deficient patients versus CDA 4/448 (< 1%), CPG–DDS 6/221 (3%) in G6PD-normal patients. No deaths occurred. CDA was more efficacious than CPG–DDS. However, the hemolytic potential in G6PD-deficient patients does not support further development of CDA.

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