Comparative efficacy of antimalarial drugs including ACTs in the treatment of uncomplicated malaria among children under 5 years in Ghana
Comparative efficacy of antimalarial drugs including ACTs in the treatment of uncomplicated malaria among children under 5 years in Ghana
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DOI：
10.1016/j.actatropica.2005.06.018
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发表时间：
2005-09-01
期刊：
影响因子：
2.7
通讯作者：
Quashie, N
中科院分区：
文献类型：
--
作者：
Koram, KA;Abuaku, B;Quashie, N
恶性疟原虫对氯喹和磺胺/乙胺嘧啶等常用抗疟疾药物的抗药性的出现和蔓延给撒哈拉以南非洲的疟疾防治工作带来了重大挑战。2003年，我们对一些抗疟疾药物的疗效进行了研究，以支持国家疟疾控制方案审查加纳的抗疟疾药物治疗政策。6-59个月大的儿童被随机分成四个治疗组，并进行了最长28天的随访，这些儿童的症状/体征不复杂，包括腋窝温度为37.5摄氏度；感染了恶性疟原虫；以及父母愿意同意。治疗组为氯喹(CHQ)、磺胺嘧啶/乙胺嘧啶(SP)、阿莫地喹+青蒿琥酯(ADQ+ART)、蒿甲醚+鲁米芬(Coartem(R))。对168例患儿的临床评价显示，28天时ADQ+ART组累计预矫正治愈率为100%，Coartem组为97.5%，SP组为60%，CHQ组为25%。以青蒿素为基础的联合用药可迅速引起发热和寄生虫清除。配子细胞症的患病率在SP组中最高，而CHQ组在LIP随访期间没有显示出任何显著的血红蛋白水平变化，这一发现与目前在CHQ失败高的地区(如加纳)使用青蒿素联合治疗无并发症疟疾的建议是一致的。(C)2005 Elsevier B.V.保留所有权利。
The emergence and spread of Plasmodium falciparum resistance to commonly used antimalarials such as chloroquine and sulphadoxine/pyrimethamine poses major challenges to malaria control in sub-Saharan Africa. We undertook a study on the efficacy of some antimalarial drugs in 2003 with the view of supporting the National Malaria Control Programme in the review of the antimalarial drug treatment policy in Ghana. Children aged 6-59 months with signs/symptoms of uncomplicated malaria including axillary temperature >= 37.5 degrees C; mono infection with P. falciparum; and parent's willingness to give consent, were randomized into four treatment groups and followed up for a maximum of 28 days. The treatment groups were chloroquine (CHQ), sulphadoxine/pyrimethamine (SP), amodiaquine + artesunate (ADQ + ART) combination, and artemether + lumefantrine (Coartem (R)) combination. Clinical evaluation of 168 children studied showed that cumulative per-corrected cure rates on day 28 were 100% for ADQ + ART; 97.5% for coartem, 60% for SP and 25% for CHQ. The artemisinin-based combinations effected rapid fever and parasite clearance. Prevalence of gametocytaemia was highest in the SP group whilst the CHQ group did not show any significant changes in haemoglobin levels during the follow-Lip period, The findings are in agreement with current recommendations for using artemisinin-based combinations for treating uncomplicated malaria in areas of high CHQ failure such as Ghana. (c) 2005 Elsevier B.V. All rights reserved.