%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Ndounga, M.
%A Mayengue, P. I.
%A Tahar, Rachida
%A Casimiro, P. N.
%A Maya, D. W. M.
%A Miakassissa Mpassi, V.
%A Malonga, D. A.
%A Nsonde Ntandou, F.
%A Mallanda, G.
%A Ringwald, Pascal
%A Basco, Leonardo
%A Ntoumi, F.
%T Efficacy of sulfadoxine-pyrimethamine, amodiaquine, and sulfadoxine-pyrimethamine-amodiaquine combination for the treatment of uncomplicated falciparum malaria in the urban and suburban areas of Brazzaville (Congo)
%D 2007
%L fdi:010040790
%G ENG
%J Acta Tropica
%@ 0001-706X
%K drug resistance ; clinical study ; plasmodiumfalciparum ; chloroquine ; drug combinations
%K CONGO
%K BRAZZAVILLE
%M CC:0002497732-0002
%N 3
%P 163-171
%R 10.1016/j.actatropica.2007.06.002
%U https://www.documentation.ird.fr/hor/fdi:010040790
%> https://www.documentation.ird.fr/intranet/publi/2007/11/010040790.pdf
%V 103
%W Horizon (IRD)
%X Congo-Brazzaville has recently adopted artesunate-amodiaquine as the first-line antimalarial drug to replace chloroquine. Before the implementation of this new strategy, we conducted several clinical studies to assess the therapeutic efficacy of former, classical first-line antimalarial drugs in the city of Brazzaville, in which reside about 30% of the Congolese population. From 2003 to 2005, non-randomised trials were conducted to evaluate the efficacy of sulfadoxine-pyrimethamine (SP) (n = 97 patients), amodiaquine (AQ) (n = 62 patients), and the combination of sulfadoxine-pyrimethamine-amodiaquine (n = 54 patients) in children aged between 6 months and 5 years with uncomplicated malaria using the 2003 WHO guidelines during the 28-day follow-up period. After excluding new infections by PCR, the proportion of treatment failure on day 28 was 30.2% (95% confidence interval, 19.2-43.0%) for sulfadoxine-pyrimethamine, 34.8% (95% confidence interval, 21.4-50.2%) for amodiaquine, and 14.2% (95% confidence interval, 5.9-27.2%) for sulfadoxine-pyrimethamine + amodiaquine combination. Treatment with sulfadoxine-pyrimethamine was associated with an increase of gametocyte charge. These results suggest that neither sulfadoxine-pyrimethamine nor amodiaquine is efficacious as monotherapy and that their combination may not remain effective in the coming years. Based on our results, the implementation of artemisinin-based combination therapy appears to be urgent in the country.
%$ 052