title: Randomized clinical trial of artemisinin versus non-artemisinin combination therapy for uncomplicated falciparum malaria in Madagascar.
abstract: BACKGROUND
  Data concerning antimalarial combination treatment for uncomplicated malaria in Madagascar are largely lacking. Randomized clinical trial was designed to assess therapeutic efficacies of chloroquine (CQ), amodiaquine (AQ), sulphadoxine-pyrimethamine (SP), amodiaquine plus sulphadoxine-pyrimethamine combination (AQ+SP) and artesunate plus amodiaquine combination (AQ+AS).
  
  
  METHODS
  287 children between 6 months and 15 years of age, with uncomplicated falciparum malaria, were enrolled in the study. Primary endpoints were the day-14 and day-28 risks of parasitological failure, either unadjusted or adjusted by genotyping.
  
  
  RESULTS
  All treatment regimens, except for CQ treatment, gave clinical cure rates above 97% by day-14 and 92% by day-28 (PCR-corrected). AQ+SP was as effective as AQ+AS. The risk of new infection within the month after therapy was generally higher for AQ+AS than AQ+SP.
  
  
  CONCLUSIONS
  These findings show that the inexpensive and widely available combination AQ+SP may be valuable in for the treatment of uncomplicated malaria in Madagascar and could have an important role in this country, where much of the drugs administered go to patients who do not have malaria.
authors.affiliation: Malaria Unit Research, Institut Pasteur de Madagascar, BP 1274, Antananarivo, Madagascar. dmenard@pasteur.mg
authors.forename: Didier
authors.initials: D
authors.lastname: Ménard
authors.forename: Nohary Nina Harimanana
authors.initials: NN
authors.lastname: Andrianina
authors.forename: Zakaherizo
authors.initials: Z
authors.lastname: Ramiandrasoa
authors.forename: Arthur
authors.initials: A
authors.lastname: Randriamanantena
authors.forename: Noéline
authors.initials: N
authors.lastname: Rasoarilalao
authors.forename: Martial
authors.initials: M
authors.lastname: Jahevitra
authors.forename: Arsène
authors.initials: A
authors.lastname: Ratsimbasoa
authors.forename: Luciano
authors.initials: L
authors.lastname: Tuseo
authors.forename: Andrianirina
authors.initials: A
authors.lastname: Raveloson
mesh_terms: D000293:Adolescent; D000655:Amodiaquine / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D000077332:Artesunate; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D008270:Madagascar; D016778:Malaria, Falciparum / Q000188:drug therapy*; D011739:Pyrimethamine / Q000627:therapeutic use; D012717:Sesquiterpenes / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D012717:Sesquiterpenes; D000655:Amodiaquine; C001205:fanasil, pyrimethamine drug combination; D000077332:Artesunate; D013413:Sulfadoxine; D002738:Chloroquine; C031327:artemisinin; D011739:Pyrimethamine