Dihydroartemisinin suppository in moderately severe malaria: comparative efficacy of dihydroartemisinin suppository versus intramuscular artemeter followed by oral sulfadoxine-pyrimethamine in the management of moderately severe malaria in Nigerian children.
We compared two dose forms of artemisinin derivatives, dihydroartemisinin suppository (DHA) and intramuscular artemether (ART), in children 6 months to 10 years of age with moderately severe malaria for which oral therapy was not appropriate. Children were randomly allocated to receive three daily doses of DHA or ART followed by a single oral dose of sulfadoxine-pyrimethamine on the third day of both treatment regimens and were monitored for parasitologic and clinical response for 14 days. At enrollment, parasite density was 1,640-523,333/microL (geometric mean parasite density [GMPD] = 58,129/microL) in patients treated with DHA, whereas that for children who received ART was 1,440-559,400/microL (GMPD = 60,387/microL). Mean parasite and fever clearance times were similar in both groups. Days 14 and 28 parasitologic cure rates were 100% (34 of 34) and 96.2% (25 of 26) versus 96.2% (25 of 26) and 91.7% (22 of 24) for children treated with DHA and ART, respectively. In conclusion, both treatment regimens were efficacious and well tolerated.
Falade
Catherine O
CO
Malaria Research Laboratories, IMRAT, College of Medicine, University of Ibadan, Ibadan, Nigeria. fallady@scannet.com
Fadero
Francis F
FF
Happi
Christian T
CT
Dada-Adegbola
Hannah O
HO
Gbotosho
Grace O
GO
Ayede
Idowu
I
Falade
Adegoke G
AG
Oduola
Ayoade M J
AM
Salako
Lateef A
LA
D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D000077549:Artemether; D037621:Artemisinins / Q000008:administration & dosage* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology; D009549:Nigeria / Q000453:epidemiology; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D012717:Sesquiterpenes / Q000008:administration & dosage* / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use*; D013488:Suppositories
D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D012717:Sesquiterpenes; D013488:Suppositories; C001205:fanasil, pyrimethamine drug combination; C039060:artenimol; D013413:Sulfadoxine; D000077549:Artemether; D011739:Pyrimethamine