Basco Leonardo, Ngane V.F., Ndounga Mathieu, Same Ekobo A., Youmba J.C., Abodo R.T.O., Soula G. (2006). Molecular epidemiology of malaria in Cameroon. XXI. Baseline therapeutic efficacy of chloroquine, amodiaquine, and sulfadoxine-pyrimethamine monotherapies in children before national drug policy change. American Journal of Tropical Medicine and Hygiene, 75 (3), p. 388-395. ISSN 0002-9637.
Titre du document
Molecular epidemiology of malaria in Cameroon. XXI. Baseline therapeutic efficacy of chloroquine, amodiaquine, and sulfadoxine-pyrimethamine monotherapies in children before national drug policy change
Année de publication
2006
Auteurs
Basco Leonardo, Ngane V.F., Ndounga Mathieu, Same Ekobo A., Youmba J.C., Abodo R.T.O., Soula G.
Source
American Journal of Tropical Medicine and Hygiene, 2006,
75 (3), p. 388-395 ISSN 0002-9637
The availability of epidemiologic data on drug-resistant malaria based on a standardized clinical and parasitological protocol is a prerequisite for a rational therapeutic strategy to control malaria. As part of the surveillance program on the therapeutic efficacy of the first-line (chloroquine and amodiaquine) and second-line (sulfadoxine-pyrimethamine) drugs for the management of uncomplicated Plasmodium fialciparum infections, non-randomized studies were conducted in symptomatic children aged less than 10 years according to the World Health Organization protocol (14-day follow-up period) at 12 sentinel sites in Cameroon between 1999 and 2004. Of 1,407 children enrolled in the studies, 460, 444, and 503 were treated with chloroquine, amodiaquine, or sulfadoxine-pyrimethamine, respectively. Chloroquine treatment resulted in high failure rates (proportion of early and late failures, 48.6%). Amodiaquine was effective at all study sites (proportion of failures, 7.3%). Sulfadoxine-pyrimethamine therapy was less effective than amodiaquine (P < 0.05), with failures observed in 9.9% of patients. Chloroquine is no longer a viable option and has been withdrawn from the official drug outlets in Cameroon. Amodiaquine and, to a lesser extent, sulfadoxine-pyrimethamine monotherapies are still effective in Cameroon, but further development of resistance to these drugs should be delayed by the novel strategy using artemisinin-based combination therapy. Our findings indicate that amodiaquine is the most rational partner for artesunate. Studies on the efficacy of artesunate-amodiaquine combination are currently being undertaken at several sites in the country.
Plan de classement
Epidémiologie générale [050EPID]
;
Lutte [052ANOPAL04]
Description Géographique
CAMEROUN
Localisation
Fonds IRD [F B010050500] ;
Montpellier (Centre IRD)
Identifiant IRD
fdi:010050500
