title: [Efficacy of therapeutic combinations with artemisinin derivatives in the treatment of non complicated malaria in Burundi].
abstract: Faced with the problem of resistance to chloroquine and sulfadoxine-pyrimethamine, the Ministry of Public Health of Burundi decided to study the efficacy of two artemisinin-based combinations, the fixed combination of artemether-lumefantrine and the combination of amodiaquine + artesunate. The efficacy of these combinations for the treatment of uncomplicated falciparum malaria was studied in two sites representative of the country, in Kigobe neighbourhood of Bujumbura, the capital city, and in Buhiga, a rural area. The study followed the standardized WHO protocol from October 2001 to November 2002. A total of 295 children under 5 years were included; 153 children were treated with artesunate and amodiaquine (77 at Buhiga and 76 at Kigobe), and 142 children with the combination of artemether-lumefantrine (64 at Buhiga and 78 at Kigobe). Among the 295 children, 290 were followed up to 14 days. In the group of 149 children treated with artesunate and amodiaquine, 142 (95.3%, 95% CI: 91.9-98.7%) presented with adequate clinical and parasitological response, five (3.3%) with late parasitological failure, one (0.7%) with late clinical failure and one (0.7%) with early treatment failure. Among the 141 children treated with artemether-lumefantrine, 140 (99.3%, 95% CI: 97.9-100%) presented with adequate clinical and parasitological response and one (0.7%) with late parasitological failure at Buhiga. Side-effects were comparable in both groups except for the vomiting. Vomiting was more frequent in the artesunate + amodiaquine on D1 and D2. Both treatments decreased the gametocyte carriage but without getting full clearance in all the patients. During a consensus workshop, the Ministry of Public Health agreed on the combination of artesunate and amodiaquine as the first line drug for the treatment of uncomplicated falciparum malaria in Burundi including epidemic outbreak.
authors.affiliation: Faculté de Médecine, Université du Burundi, Bujumbura, Burundi.
authors.forename: Athanase
authors.initials: A
authors.lastname: Ndayiragije
authors.forename: Déo
authors.initials: D
authors.lastname: Niyungeko
authors.forename: Jeanne
authors.initials: J
authors.lastname: Karenzo
authors.forename: Ernest
authors.initials: E
authors.lastname: Niyungeko
authors.forename: Marianne
authors.initials: M
authors.lastname: Barutwanayo
authors.forename: Alphonse
authors.initials: A
authors.lastname: Ciza
authors.forename: Andrea
authors.initials: A
authors.lastname: Bosman
authors.forename: Roger
authors.initials: R
authors.lastname: Moyou-Somo
authors.forename: Adélaïde
authors.initials: A
authors.lastname: Nahimana
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Nyarushatsi
authors.forename: Tharcisse
authors.initials: T
authors.lastname: Barihuta
authors.forename: Liévin
authors.initials: L
authors.lastname: Mizero
authors.forename: Jérome
authors.initials: J
authors.lastname: Ndaruhutse
authors.forename: Charles
authors.initials: C
authors.lastname: Delacollette
authors.forename: Pascal
authors.initials: P
authors.lastname: Ringwald
authors.forename: Jean
authors.initials: J
authors.lastname: Kamana
mesh_terms: D000655:Amodiaquine / Q000009:adverse effects / Q000627:therapeutic use; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D000077549:Artemether; D037621:Artemisinins / Q000009:adverse effects / Q000627:therapeutic use*; D000077332:Artesunate; D002063:Burundi / Q000453:epidemiology; D002675:Child, Preschool; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005449:Fluorenes / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D000078102:Lumefantrine; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D012423:Rural Health; D012717:Sesquiterpenes / Q000009:adverse effects / Q000627:therapeutic use; D017211:Treatment Failure; D014504:Urban Health; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004983:Ethanolamines; D005449:Fluorenes; D012717:Sesquiterpenes; D000655:Amodiaquine; D000077332:Artesunate; D000077549:Artemether; D000078102:Lumefantrine