title: High efficacy of two artemisinin-based combinations (artesunate + amodiaquine and artemether + lumefantrine) in Caala, Central Angola.
abstract: 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.
authors.affiliation: Epicentre, Paris, France; Médecins Sans Frontières, Paris, France. jguthmann@epicentre.msf.org
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Guthmann
authors.forename: Sandra
authors.initials: S
authors.lastname: Cohuet
authors.forename: Christine
authors.initials: C
authors.lastname: Rigutto
authors.forename: Filomeno
authors.initials: F
authors.lastname: Fortes
authors.forename: Nilton
authors.initials: N
authors.lastname: Saraiva
authors.forename: James
authors.initials: J
authors.lastname: Kiguli
authors.forename: Juliet
authors.initials: J
authors.lastname: Kyomuhendo
authors.forename: Max
authors.initials: M
authors.lastname: Francis
authors.forename: Frédéric
authors.initials: F
authors.lastname: Noël
authors.forename: Maryline
authors.initials: M
authors.lastname: Mulemba
authors.forename: Suna
authors.initials: S
authors.lastname: Balkan
mesh_terms: D000655:Amodiaquine / Q000008:administration & dosage / Q000494:pharmacology; D000810:Angola; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage* / Q000494:pharmacology / Q000592:standards; D000077549:Artemether; D037621:Artemisinins / Q000008:administration & dosage* / Q000494:pharmacology; D000077332:Artesunate; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D005449:Fluorenes / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007223:Infant; D000078102:Lumefantrine; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D012717:Sesquiterpenes / Q000008:administration & dosage / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004983:Ethanolamines; D005449:Fluorenes; D012717:Sesquiterpenes; D000655:Amodiaquine; D000077332:Artesunate; D000077549:Artemether; D000078102:Lumefantrine