@article{fdi:010048282,
  title = {{D}osing accuracy of artesunate and amodiaquine as treatment for falciparum malaria in {C}asamance, {S}enegal},
  author = {{B}rasseur, {P}hilippe and {A}gnamey, {P}. and {G}aye, {O}. and {C}isse, {M}. and {B}adiane, {M}. and {V}aillant, {M}. and {T}aylor, {W}. {R}. {J}. and {O}lliaro, {P}.},
  abstract = {{S}everal products of artesunate plus amodiaquine ({AS} + {AQ}) are being deployed in malaria-endemic countries for treating uncomplicated falciparum malaria but dosing accuracy and consequential effects on efficacy and tolerability have not been examined. {P}atients with parasitologically confirmed, uncomplicated falciparum malaria were treated and followed by research teams or local health centre staff in {C}asamance, {S}enegal. {AS} + {AQ} was given as: (i) loose combination ({AS} 50 mg, {AQ} 200 mg), dosed on body weight, or (ii) co-blistered product ({AS} 50 mg, {AQ} 153 mg) dosed by weight or age. {T}arget doses were: (i) {AS} 4 (2-10) mg/kg/day and (ii) {AQ} 10 (7.5-15) mg/kg/day. {P}atients receiving therapeutic doses defined dosing accuracy. {T}reatment-emergent signs and symptoms ({TESS}) were recorded. {A} total of 3277 patients were treated with loose (n = 1972, weight-dosed) or co-blistered (n = 1305, 962 age-dosed, 343 weight-dosed) {AS} + {AQ} by the research team (n = 966) or clinic staff (n = 2311). {AS} was dosed correctly in > 99% with all regimens. {L}oose {AQ} by weight was 98% correct. {T}he co-blister {AQ} overdosed 18% of patients when dosed by age and underdosed 13% by weight. {L}ow weight was an independent risk factor for overdosing. {T}he co-blister had significantly more {TESS} than the loose product [117/1305 (9%) vs. 41/1972 (2%), relative risk = 4.3 (95% {CI}: 3.0-6.1, {P} < 0.0001)]. {A}ge-based dosing accounted for the difference. {TESS} occurred mostly within one day (72%) and were mild or moderate (75%). {A}rtesunate is easier to dose than {AQ}. {C}urrently available age-dosed, co-blistered {AS} + {AQ} tends to overdose {AQ} and is less well tolerated than loose tablets. {I}t is not the optimal presentation of {AS} + {AQ}.},
  keywords = {falciparum malaria ; artesunate ; amodiaqine ; dosing ; presentation ; {S}enegal},
  journal = {{T}ropical {M}edicine and {I}nternational {H}ealth},
  volume = {14},
  numero = {1},
  pages = {79--87},
  ISSN = {1360-2276},
  year = {2009},
  DOI = {10.1111/j.1365-3156.2008.02190.x},
  URL = {http://www.documentation.ird.fr/hor/fdi:010048282},
}