Comparison of different artemisinin-based combinations for the treatment of Plasmodium falciparum malaria in children in Kigali, Rwanda, an area of resistance to sulfadoxine-pyrimethamine: artesunate plus sulfadoxine/pyrimethamine versus artesunate plus sulfamethoxypyrazine/pyrimethamine.
In view of the changing policy towards artemisinin-based combination therapies (ACTs), the efficacy, tolerance, and degree of re-infection of two ACTs were investigated: artesunate plus sulfadoxine/pyrimethamine (As + SP) and AS plus sulfamethoxypyrazine/pyrimethamine (As + SMP). One hundred three children were assigned to receive As + SP and 109 to receive As + SMP. In spite of the high incidence of resistance to SP, As + SP showed satisfactory results consistent with recent recommendations for ACTs (adequate clinical and parasitologic response on day 28 [ACPR] > or = 90%), but results with As + SMP fulfilled the most stringent criteria (ACPR > or = 95%). The absence of side effects and the low price of these drugs make them it worth to reconsider national therapies in favor of either of these two drug combinations.
Rulisa
Stephen
S
Central University Hospital of Kigali, Kigali, Rwanda. stevenruse@yahoo.com
Gatarayiha
Jean Philip
JP
Kabarisa
Tharcisse
T
Ndayisaba
Gill
G
D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000008:administration & dosage / Q000627:therapeutic use*; D000077332:Artesunate; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D018432:Drug Resistance, Multiple; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D011739:Pyrimethamine / Q000627:therapeutic use*; D012432:Rwanda; D012717:Sesquiterpenes / Q000008:administration & dosage / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use*; D013415:Sulfalene / Q000627:therapeutic use*
D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D006454:Hemoglobins; D012717:Sesquiterpenes; C001205:fanasil, pyrimethamine drug combination; D000077332:Artesunate; D013413:Sulfadoxine; D013415:Sulfalene; D011739:Pyrimethamine