title: A randomized comparative study of chloroquine, amodiaquine and sulphadoxine-pyrimethamine for the treatment of uncomplicated malaria in Ghana.
abstract: The study examined the efficacy of chloroquine (CQ), amodiaquine (AQ) and sulphadoxine-pyrimethamine (SP) for the treatment of uncomplicated Plasmodium falciparum malaria in Ghana. A total of 351 children were randomized to receive either of the three study drugs. Patients were evaluated using the WHO 14-day in vivo antimalarial testing guidelines. The 14-day adequate clinical and parasitological response analysis revealed that CQ, 46.7% (95% CI 37.5, 56.0) has the least efficacy compared with AQ, 86.1% (95% CI 78.3, 91.8) and SP, 77.6% (95% CI 68.9, 84.8). Late parasite failures were also lower and similar in the AQ and SP (9.6% and 10.3%) than in the CQ (32.5%) group. However, CQ and AQ groups showed better fever clearance compared with SP throughout except for day 7 and after when possibly due to its significant late clinical failures, clearance by CQ was lower. Our findings suggest that CQ is no longer useful in Ghana and should be replaced as a first-line treatment of malaria. Replacement of CQ preferably with AQ combination treatment will be an effective and an affordable alternative for the treatment of uncomplicated malaria.
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana. aoduro@navrongo.mimcom.net
authors.forename: Abraham R
authors.initials: AR
authors.lastname: Oduro
authors.forename: Thomas
authors.initials: T
authors.lastname: Anyorigiya
authors.forename: Abraham
authors.initials: A
authors.lastname: Hodgson
authors.forename: Patrick
authors.initials: P
authors.lastname: Ansah
authors.forename: Francis
authors.initials: F
authors.lastname: Anto
authors.forename: Nana A
authors.initials: NA
authors.lastname: Ansah
authors.forename: Frank
authors.initials: F
authors.lastname: Atuguba
authors.forename: George
authors.initials: G
authors.lastname: Mumuni
authors.forename: Joseph
authors.initials: J
authors.lastname: Amankwa
mesh_terms: D000655:Amodiaquine / Q000009:adverse effects / Q000627:therapeutic use; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D002738:Chloroquine / Q000009:adverse effects / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000469:parasitology; D005869:Ghana; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D018512:Parasitemia / Q000188:drug therapy; D010352:Patient Dropouts; D011739:Pyrimethamine / Q000009:adverse effects / Q000627:therapeutic use; D013413:Sulfadoxine / Q000009:adverse effects / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D000655:Amodiaquine; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011739:Pyrimethamine