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Am. J. Trop. Med. Hyg., 75(1), 2006, pp. 143-145
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


HIGH EFFICACY OF TWO ARTEMISININ-BASED COMBINATIONS (ARTESUNATE + AMODIAQUINE AND ARTEMETHER + LUMEFANTRINE) IN CAALA, CENTRAL ANGOLA

JEAN-PAUL GUTHMANN*, SANDRA COHUET, CHRISTINE RIGUTTO, FILOMENO FORTES, NILTON SARAIVA, JAMES KIGULI, JULIET KYOMUHENDO, MAX FRANCIS, FRÉDÉRIC NOËL, MARYLINE MULEMBA, AND SUNA BALKAN
Epicentre, Paris, France; Médecins Sans Frontières, Paris, France; Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola; Mbarara University of Science and Technology, Mbarara, Uganda

 

ABSTRACT

In April 2004, 137 children 6–59 months of age with uncomplicated Plasmodium falciparum (Pf) malaria (Caala, Central Angola) were randomized to receive either artemether-lumefantrine (Coartem) or artesunate + amodiaquine (ASAQ). After 28 days of follow-up, there were 2/61 (3.2%) recurrent parasitemias in the Coartem group and 4/64 (6.2%) in the ASAQ group (P = 0.72), all classified as re-infections after PCR genotyping (cure rate = 100% [95%CI: 94–100] in both groups). Only one patient (ASAQ group) had gametocytes on day 28 versus five (Coartem) and three (ASAQ) at baseline. Compared with baseline, anemia was significantly improved after 28 days of follow-up in both groups (Coartem: from 54.1% to 13.4%; ASAQ: from 53.1% to 15.9%). Our findings are in favor of a high efficacy of both combinations in Caala. Now that Coartem has been chosen as the new first-line anti-malarial, the challenge is to insure that this drug is available and adequately used.

Received February 20, 2006. Accepted for publication March 1, 2006.

Financial support: This study was funded by Médecins sans Frontières. The American Society of Tropical Medicine and Hygiene (ASTMH) and the American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH) assisted with publication expenses.

* Address correspondence to Jean-Paul Guthmann, Epicentre, 8 rue Saint Sabin, 75011 Paris, France. E-mail: jguthmann{at}epicentre.msf.org

Authors’ addresses: Jean-Paul Guthmann, Sandra Cohuet, Epicentre, 8 rue Saint Sabin, 75011 Paris, France, Telephone: 33 1 40 21 28 06, Fax: 33 1 40 21 28 03, E-mail: jguthmann{at}epicentre.msf.org. Christine Rigutto, Max Francis, Frédéric Noël, Maryline Mulemba, and Suna Balkan, Médecins sans Frontières, 4 rue Saint Sabin, 75011 Paris, France. Filomeno Fortes and Nilton Saraiva, Programa Nacional de Controlo da Malária, Ministerio da Saúde, Luanda, Angola. James Kiguli and Juliet Kyomuhendo, Mbarara University of Science and Technology, PO Box 1410, Mbarara, Uganda, Telephone: 256 77 576 396, Fax: 256 48 520 782.

Reprints requests: Jean-Paul Guthmann, Epicentre, 8 rue Saint Sabin, 75011 Paris, France. E-mail: jguthmann{at}epicentre.msf.org.




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Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.