AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 77(2), 2007, pp. 235-241
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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Therapeutic Efficacy and Effects of Artemether-Lumefantrine and Amodiaquine-Sulfalene-Pyrimethamine on Gametocyte Carriage in Children with Uncomplicated Plasmodium falciparum Malaria in Southwestern Nigeria

Akintunde Sowunmi*, Grace O. Gbotosho, Christian T. Happi, Ahmed A. Adedeji, Fatai A. Fehintola, Onikepe A. Folarin, Ernest Tambo, AND Babasola A. Fateye
Department of Pharmacology and Therapeutics and Institute for Medical Research and Training, University of Ibadan, Ibadan, Nigeria

The treatment efficacy and effects of artemether-lumefantrine (AL) and amodiaquine-sulfalene-pyrimethamine (ASP) on gametocyte carriage were evaluated in 181 children ≤ 10 years of age with uncomplicated Plasmodium falciparum malaria randomized to receive either drug combination. All children recovered clinically. Fever clearance times were similar. The rate of P. falciparum reappearance (recrudescence or re-infection) between two and six weeks after the start of therapy was significantly higher in AL-treated children (P = 0.01). Parasite clearance was significantly faster in children treated with AL (mean ± SD = 1.7 ± 0.6 days, 95% confidence interval = 1.58 – 1.83, P = 0.0001) but the polymerase chain reaction–corrected cure rate (90 of 91 versus 84 of 90) and the rate of resolution of malaria-related anemia two weeks after treatment began (45 of 50 versus 33 of 46) were higher in children treated with ASP. Gametocyte carriage rates were similar. Both regimens were well tolerated. Artemether-lumefantrine clears parasitemia more rapidly than ASP but both combinations are effective in treatment of uncomplicated P. falciparum malaria in Nigerian children.

Received December 14, 2006. Accepted for publication April 24, 2007.

Acknowledgments: We thank Drs. Chris Migom and Segun Dogunro for their unparalleled support, and our clinic staff, especially Moji Amao and Adeola Alabi, for assistance with the study. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.

Financial support: The study was supported by Pfizer Global Pharmaceuticals.

* Address correspondence to Akintunde Sowunmi, Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria. E-mail: akinsowunmi{at}hotmail.com

Authors’ addresses: Akintunde Sowunmi, Grace O. Gbotosho, Christian T. Happi, Ahmed A. Adedeji, Fatai A. Fehintola, Onikepe A. Folarin, Ernest Tambo, and Babasola A. Fateye, Department of Pharmacology and Therapeutics and Institute for Medical Research and Training, University College Hospital, University of Ibadan, Ibadan, Nigeria, Telephone: 234-2-241-2101, Fax: 234-2-241-1843, E-mail: akinsowunmi{at}hotmail.com.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.