title: Efficacy of sulphadoxine-pyrimethamine + artesunate, sulphadoxine-pyrimethamine + amodiaquine, and sulphadoxine-pyrimethamine alone in uncomplicated falciparum malaria in Mali.
abstract: BACKGROUND
  Plasmodium falciparum resistance to artemisinin has been reported in South-East Asia. Long half-life drugs are increasingly being used for malaria prevention. The potential spread of parasite resistance to these regimens is real and makes regular efficacy surveillance a priority.
  
  
  METHODS
  From August to December 2004 and July to December 2005, a randomized open label trial of sulphadoxine-pyrimethamine (SP) + artesunate (AS) versus SP + amodiaquine (AQ), and SP alone, was conducted in two villages of Mali. PCR was used to distinguish new infections from recrudescent P. falciparum infections. Patients were followed for 28 days to assess treatment efficacy.
  
  
  RESULTS
  Overall 912 children aged between six to 59 months, with uncomplicated P. falciparum malaria were recruited. Baseline characteristics were similar in the three treatment arms. Crude ACPRs were 94.9%; 98.6% and 93.5% for SP + AS; SP + AQ and SP alone arms respectively (SP + AS versus SP + AQ, p = 0.01; SP + AS versus SP, p = 0.5; SP + AQ versus SP, p = 0.001). After PCR adjustment, cACPRs were 99%; 100% and 97.2% for SP + AS; SP + AQ and SP alone arms, respectively (SP + AS versus SP + AQ, p = 0.25; SP + AS versus SP, p = 0.12; SP + AQ versus SP, p = 0.007).
  
  
  CONCLUSIONS
  Sulphadoxine-pyrimethamine + amodiaquine therapy was as efficacious as sulphadoxine-pyrimethamine + artesunate, but more efficacious than sulphadoxine-pyrimethamine alone in the treatment of uncomplicated P. falciparum malaria in Mali.
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. hmaiga@icermali.org.
authors.forename: Hamma
authors.initials: H
authors.lastname: Maiga
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. adjimde@icermali.org.
authors.forename: Abdoulaye A
authors.initials: AA
authors.lastname: Djimde
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. beavoguia_h@yahoo.com.
authors.forename: Abdoul H
authors.initials: AH
authors.lastname: Beavogui
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. obtoure@icermali.org.
authors.forename: Ousmane
authors.initials: O
authors.lastname: Toure
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. mtekete@icermali.org.
authors.forename: Mamadou
authors.initials: M
authors.lastname: Tekete
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. oumar@icermali.org.
authors.forename: Cheick Papa O
authors.initials: CP
authors.lastname: Sangare
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. tonydara@icermali.org.
authors.forename: Antoine
authors.initials: A
authors.lastname: Dara
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. zouisaac@gmail.com.
authors.forename: Zoumana I
authors.initials: ZI
authors.lastname: Traore
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. bila@icermali.org.
authors.forename: Oumar B
authors.initials: OB
authors.lastname: Traore
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. dama@icermali.org.
authors.forename: Souleymane
authors.initials: S
authors.lastname: Dama
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. chris_ndong@hotmail.com.
authors.forename: Christelle
authors.initials: C
authors.lastname: N'Dong
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. hniangaly@icermali.org.
authors.forename: Hamidou
authors.initials: H
authors.lastname: Niangaly
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. nouhoumd@icermali.org.
authors.forename: Nouhoum
authors.initials: N
authors.lastname: Diallo
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. ddembele@icermali.org.
authors.forename: Demba
authors.initials: D
authors.lastname: Dembele
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. isagara@icermali.org.
authors.forename: Issaka
authors.initials: I
authors.lastname: Sagara
authors.affiliation: Molecular Epidemiology and Drug Resistance Unit, University of Sciences Techniques and Technology of Bamako, PO Box: 1805, Bamako, Mali. okd@icermali.org.
authors.forename: Ogobara K
authors.initials: OK
authors.lastname: Doumbo
mesh_terms: D000655:Amodiaquine / Q000627:therapeutic use*; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D002675:Child, Preschool; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D008302:Mali; D011739:Pyrimethamine / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; C578917:sulfadoxine-pyrimethamine-artesunate; D000655:Amodiaquine; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine