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    <titleInfo>
      <title>Efficacy of artesunate plus amodiaquine, artesunate plus sulfadoxine-pyrimethamine, and chloroquine plus sulfadoxine-pyrimethamine in patients with uncomplicated Plasmodium falciparum in the Comoros Union</title>
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    <name type="personnal">
      <namePart type="family">Rabarijaona</namePart>
      <namePart type="given">L. P.</namePart>
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    <name type="personnal">
      <namePart type="family">Robert</namePart>
      <namePart type="given">Vincent</namePart>
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    <name type="personnal">
      <namePart type="family">Bedja</namePart>
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    <name type="personnal">
      <namePart type="family">Randrianarivelojosia</namePart>
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    <abstract>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 &lt; 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.</abstract>
    <targetAudience authority="marctarget">specialized</targetAudience>
    <subject>
      <topic>malaria</topic>
      <topic>Comoros union</topic>
      <topic>ACT</topic>
      <topic>artesunate</topic>
      <topic>amodiaquine</topic>
      <topic>drug policy</topic>
    </subject>
    <classification authority="local">052</classification>
    <relatedItem type="host">
      <titleInfo>
        <title>Acta Tropica</title>
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      <part>
        <detail type="volume">
          <number>102</number>
        </detail>
        <detail type="volume">
          <number>3</number>
        </detail>
        <extent unit="pages">
          <list> 176-181</list>
        </extent>
      </part>
      <originInfo>
        <dateIssued>2007</dateIssued>
      </originInfo>
      <identifier type="issn">0001-706X</identifier>
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    <identifier type="uri">https://www.documentation.ird.fr/hor/fdi:010040714</identifier>
    <identifier type="doi">10.1016/j.actatropica.2007.03.004</identifier>
    <identifier type="issn">0001-706X</identifier>
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      <recordCreationDate encoding="w3cdtf">2007-11-06</recordCreationDate>
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