Therapeutic efficacy of chloroquine plus sulphadoxine/pyrimethamine compared with monotherapy with either chloroquine or sulphadoxine/pyrimethamine in uncomplicated Plasmodium falciparum malaria in Laos
Therapeutic efficacy of chloroquine plus sulphadoxine/pyrimethamine compared with monotherapy with either chloroquine or sulphadoxine/pyrimethamine in uncomplicated Plasmodium falciparum malaria in Laos
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DOI：
10.1046/j.1365-3156.2003.00977.x
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发表时间：
2003-01-01
影响因子：
3.3
通讯作者：
Jelinek, T
中科院分区：
文献类型：
--
作者：
Schwöbel, B;Jordan, S;Jelinek, T
在老挝南部边境省份，我们比较了抗疟药联合治疗年龄大于或等于1岁的无并发症恶性疟原虫疟疾患者的疗效：甲氟喹（MQ）、氯喹（CQ）或磺胺嘧啶/乙胺嘧啶（SP）单药治疗与CQ与SP联合治疗，随访14 d。在265名恶性疟原虫阳性患者中，有119人参加了药物试验。CQ组早期或晚期治疗失败的患者明显多于SP组[44.8%vs . 17.9%，相对危险度（RR）= 2.51，95%CI 1.03-6.12]。在SP组中，82.1%是敏感的，17.9%是治疗失败的。CQ + SP联合治疗的敏感性为83.3%，治疗失败率为16.7%。联合治疗与SP单药治疗相比无优势（RR = 1.01，95% CI 0.8-1.3）。所有接受MQ治疗（总剂量25 mg/kg）的患者均在随访14天内治愈。这项研究的结果表明，在老挝人民民主共和国使用CQ作为无并发症疟疾的一线治疗必须重新考虑。CQ和SP的联合治疗已被讨论为具有成本效益的替代治疗，但在我们的患者人群中，并没有比SP单药治疗获得更好的结果。
In a southern border province of Lao PDR, we compared the efficacy of antimalarial drug combinations in patients aged greater than or equal to1 year with uncomplicated Plasmodium falciparum malaria: monotherapy with either mefloquine (MQ), chloroquine (CQ), or sulphadoxine/pyrimethamine (SP) vs . the combination of both CQ and SP. Follow-up time was 14 days. Of 265 P. falciparum positive patients, 119 were enrolled in the drug trial. Significantly more patients treated with CQ than with SP developed early or late treatment failure [44.8%vs . 17.9%, relative risk (RR) = 2.51, 95% CI 1.03-6.12]. In the SP group, 82.1% were sensitive and 17.9% were treatment failures. The combination treatment CQ plus SP resulted in 83.3% sensitivity and 16.7% treatment failures. Combination treatment has no advantage over monotherapy with SP (RR = 1.01, 95% CI 0.8-1.3). All patients who received MQ for treatment (total dose 25 mg/kg) were cured within the 14 days of follow-up. The findings of this study suggest that use of CQ as first-line treatment of uncomplicated malaria in the Lao PDR has to be reconsidered. The combination of both CQ and SP has been discussed as a cost-effective alternative treatment, but in our patient population achieved no better results than single therapy with SP.