Antimalarial efficacy of chloroquine, amodiaquine, sulfadoxine-pyrimethamine, and the combinations of amodiaquine plus artesunate and sulfadoxine-pyrimethamine plus artesunate in Huambo and Bie provinces, central Angola
Antimalarial efficacy of chloroquine, amodiaquine, sulfadoxine-pyrimethamine, and the combinations of amodiaquine plus artesunate and sulfadoxine-pyrimethamine plus artesunate in Huambo and Bie provinces, central Angola
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DOI：
10.1016/j.trstmh.2004.11.010
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发表时间：
2005-07-01
影响因子：
2.2
通讯作者：
Legros, D
中科院分区：
文献类型：
--
作者：
Guthmann, JP;Ampuero, J;Legros, D
我们于 2002 年和 2003 年在安哥拉的卡拉和奎托研究了三种抗疟治疗方法。我们在卡拉测试了氯喹 (CQ)、阿莫地喹 (AQ) 和磺胺多辛-乙胺嘧啶 (SP)，在奎托测试了 AQ、SP 以及 AQ + 青蒿酯 (AQ + AS) 和 SP + 青蒿酯 (SP + AS) 的组合。对总共 619 名患有无并发症的恶性疟原虫疟疾的儿童（卡拉 240 名，奎托 379 名）进行了为期 28 天的随访，通过 PCR 基因分型来区分复发与再感染。第 28 天的 PCR 校正失败比例在 CQ 组中非常高（83.5%，95% CI 74.1-90.5），在 SP 组中也很高（Caala：25.3%，95% CI 16.7-35.8；Kuito：38.8%，95% CI 28.4-50.0），在 AQ 组中约为 20%（Caala： 17.3%，95% CI 10.0-27.2；Kuito：21.6%，95% CI 14.3-30.6），并且在基于青蒿素的联合治疗组中非常低（AQ +AS 和 SP +AS 每种组合的 1.2%，95% CI 0.0-6.4），这些结果表明 CQ 和 SP 在 Caala 和 Kuito 中不再有效，并且如果作为单一疗法使用，AQ 的中等疗效可能会在短期内受到损害。我们建议将 AQ 与 AS 一起使用，但由于 AQ 耐药，这种组合可能不会有很长的治疗寿命。 (c) 2005 年皇家热带医学和卫生学会。由爱思唯尔有限公司出版。保留所有权利。
We studied three antimalarial treatments in Caala and Kuito, Angola, in 2002 and 2003. We tested chloroquine (CQ), amodiaquine (AQ) and sulfadoxine-pyrimethamine (SP) in Caala, and AQ, SP and the combinations AQ + artesunate (AQ + AS) and SP + artesunate (SP + AS) in Kuito. A total of 619 children (240 in Caala, 379 in Kuito) with uncomplicated Plasmodium falciparum malaria were followed-up for 28 days, with PCR genotyping to distinguish recrudescence from reinfection. PCR-corrected failure proportions at day 28 were very high in the CQ group (83.5%, 95% CI 74.1-90.5), high in the SP groups (Caala: 25.3%, 95% CI 16.7-35.8; Kuito: 38.8%, 95% CI 28.4-50.0), around 20% in the AQ groups (Caala: 17.3%, 95% CI 10.0-27.2; Kuito: 21.6%, 95% CI 14.3-30.6) and very low in the artemisinin-based combination groups (1.2%, 95% CI 0.0-6.4 for each combination AQ +AS and SP +AS), These results show that CQ and SP are no longer efficacious in Caala and Kuito and that the moderate efficacy of AQ is likely to be compromised in the short term if used as monotherapy. We recommend the use of AQ with AS, though this combination might not have a tong useful therapeutic life because of AQ resistance. (c) 2005 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.