Ndounga M. auteur aut IRD Mayengue P. I. auteur aut IRD Tahar Rachida auteur aut IRD Casimiro P. N. auteur aut IRD Maya D. W. M. auteur aut IRD Miakassissa Mpassi V. auteur aut IRD Malonga D. A. auteur aut IRD Nsonde Ntandou F. auteur aut IRD Mallanda G. auteur aut IRD Ringwald Pascal auteur aut IRD Basco Leonardo auteur aut IRD Ntoumi F. auteur aut IRD text journalArticle eng text/pdf born digital access 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. specialized drug resistance clinical study plasmodiumfalciparum chloroquine drug combinations CONGO 052 103 3 163-171 2007 0001-706X https://www.documentation.ird.fr/hor/fdi:010040790 10.1016/j.actatropica.2007.06.002 0001-706X [F B010040790] https://www.documentation.ird.fr/hor/fdi:010040790 https://www.documentation.ird.fr/intranet/publi/2007/11/010040790.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2007-12-03 2023-07-05 fdi:010040790 fre