Horizon 1 1 17 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES Acta Tropica 176-181 malaria Comoros union ACT artesunate amodiaquine drug policy 2007 fdi:010040714 ENG Acta Tropica 0001-706X CC:0002487714-0006 3 10.1016/j.actatropica.2007.03.004 https://www.documentation.ird.fr/hor/fdi:010040714 https://www.documentation.ird.fr/intranet/publi/2007/10/010040714.pdf 102 Horizon (IRD) Health policy makers in Comoros Union have considered a policy change recommending combination treatment to control malaria. We evaluated the efficacy of three antimalarial drug combinations, taken orally, to enable the authorities to make an evidence-based choice. The study was carried out in patients of 2-70 years old in Moroni, Moheli and Anjouan in 2003. We enrolled 168 patients with uncomplicated malaria from 1097 outpatients screened at the health centres. One hundred and fifty-eight patients, of whom half were under five years old, (mean age = 11.1 +/- 13.9 years), were followed up for 14 days. According to PCR adjusted outcome, the therapeutic efficacy of artesunate + amodiaquine (AS + AQ) (n = 54) and artesunate + sulfadoxine-pyrimethamine (AS + SP) (n = 53) was 100%, whereas that of chloroquine + sulfadoxine-pyrimethamine (CQ + SP) was 98% (50/51). The key difference between these treatments was the higher parasite clearance rate on Day 2 obtained with artesunate-containing combinations (P < 0.001). These results provide a baseline for monitoring changes in the susceptibility of Plasmodium falciparum to artesunate+amodiaquine and artesunate + sulfadoxine-pyrimethamine (ACTs) in the Comoros Union. Health policy changes involving the replacement of chloroquine in the Indian Ocean subregion are discussed. 052