Therapeutic efficacy of sulfadoxin/pyrimethamine in the treatment of uncomplicated Plasmodium falciparum malaria in Enseno, Meskan Woreda, Gurage zone, SNNPR, Ethiopia.
OBJECTIVE
To study the the response of Plasmodium falciparum to sulfadoxine-pyrimethamine (SP).


METHODS
A cross sectional survey was conducted between October and November 2002 to study the response of P. falciparum to the standard regimen of sulfadoxine-pyrimethamine (SP)--25 mg/kg of sulfadoxine and 1.25 mg/kg of pyrimethamin--in 70 patients (35 males, 35 females) who were seen Enseno malaria center. Gurage Zone, Sothern Nations, Nationalities, and Peoples Region (SNNPR), Ethiopia. The clinical and parasitological responses were studied until day-14 in accordance with the modified 1999 WHO in-vivo protocol for the evaluation of therapeutic efficacy of anti-malarial drugs.


RESULTS
Of 75 enrolled patients, 5 were lost to follow-up or excluded before day-14. A total of 70 patients were followed till the end of the study, among which 10 (14.3%) had treatment failure. This was noted more in children than in adults and this differenrce was statistically significant (OR = 0.14; 95% CI = 1.00, 0.025; P < 0.05 Fisher's exact test). Clinical presentation with high-grade fever on day-0 was found to be more predictive for treatment failure (P = 0.0005, Fisher's exact test).


CONCLUSIONS
The treatment failure of SP in this study lies between 6-15% (14.3%), which is called an Alert period, using an arbitrary cut off point for treatment failure. So, it should be supplemented with large-scale sensitivity studies to initiate the mechanism for the process of change and assessment of possible alternatives.
Abebe
Workeabeba
W
Department of Pediatrics, P.O. Box 2076, Addis Ababa, Ethiopia. workeabebasol@yahoo.com
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D005002:Ethiopia; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011739:Pyrimethamine / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use*; D016896:Treatment Outcome
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine