%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Tahar, Rachida
%A Almelli, T.
%A Debue, C.
%A Ngane, V. F.
%A Allico, J. D.
%A Youdom, S. W.
%A Basco, Leonardo
%T Randomized trial of artesunate-amodiaquine, atovaquone-proguanil, and artesunate-atovaquone-proguanil for the treatment of uncomplicated falciparum malaria in children
%D 2014
%L fdi:010063089
%G ENG
%J Journal of Infectious Diseases
%@ 0022-1899
%K drug resistance ; Plasmodium falciparum ; cytochrome b ; artemisinin ; molecular epidemiology
%K CAMEROUN
%M ISI:000345771200015
%N 12
%P 1962-1971
%R 10.1093/infdis/jiu341
%U https://www.documentation.ird.fr/hor/fdi:010063089
%> https://www.documentation.ird.fr/intranet/publi/2015/01/010063089.pdf
%V 210
%W Horizon (IRD)
%X Artemisinin-based combination therapies (ACTs) are recommended for the treatment of acute uncomplicated falciparum malaria in many malaria-endemic countries. Despite the emergence of artemisinin resistance, few alternative non-ACTs, including atovaquone-proguanil, are currently available. Plasmodium falciparum-infected Cameroonian children a parts per thousand currency sign5 years old (n = 338) were randomly assigned to artesunate-amodiaquine, atovaquone-proguanil, or artesunate-atovaquone-proguanil treatment groups and followed for 28 days, according to the standard World Health Organization protocol. In vitro response to atovaquone and cytochrome b sequence of clinical isolates were determined. Eight late failures and 16 failures (8 late and 8 early failures) were observed after artesunate-amodiaquine and atovaquone-proguanil therapies, respectively. Most late failures were due to reinfections. Artesunate-atovaquone-proguanil was not associated with any failure. After correction by genotyping, per-protocol analysis showed no difference in the efficacy of 3 drugs. However, the proportion of atovaquone-proguanil-treated patients with positive smears on day 3 was much higher (36.0%; P < .05) than that of the artesunate-amodiaquine (2.9%) and artesunate-atovaquone-proguanil (1.0%) groups. In vitro response and cytochrome b sequence did not indicate atovaquone resistance. Atovaquone-proguanil was characterized by a slow blood schizontocidal action and resulted in early treatment failure in a few patients. Artesunate-atovaquone-proguanil was a highly effective alternative treatment. UMIN000003813.
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