title: 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.
abstract: 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.
authors.affiliation: Central University Hospital of Kigali, Kigali, Rwanda. stevenruse@yahoo.com
authors.forename: Stephen
authors.initials: S
authors.lastname: Rulisa
authors.forename: Jean Philip
authors.initials: JP
authors.lastname: Gatarayiha
authors.forename: Tharcisse
authors.initials: T
authors.lastname: Kabarisa
authors.forename: Gill
authors.initials: G
authors.lastname: Ndayisaba
mesh_terms: 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*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D006454:Hemoglobins; D012717:Sesquiterpenes; C001205:fanasil, pyrimethamine drug combination; D000077332:Artesunate; D013413:Sulfadoxine; D013415:Sulfalene; D011739:Pyrimethamine