Back to Search Start Over

Comparison of artemether-lumefantrine with sulfadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in eastern Nepal.

Authors :
Thapa S
Hollander J
Linehan M
Cox-Singh J
Bista MB
Thakur GD
Davis WA
Davis TM
Source :
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2007 Sep; Vol. 77 (3), pp. 423-30.
Publication Year :
2007

Abstract

Because available data suggest that resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine (SP) is increasing in Nepal, an open-label, parallel-group efficacy/safety study was conducted in 99 Nepalese patients with uncomplicated falciparum malaria randomized 2:1 to artemetherlumefantrine (AL) or SP. Efficacy was assessed from clinical and microscopic evidence of treatment failure. Four SP-treated patients (12.1%; 95% CI, 4.0-29.1%) redeveloped parasitemia during the 28-day follow-up versus 0% (95% CI, 0-6.9%) in the AL group (P = 0.011), a difference that was confirmed by polymerase chain reaction (PCR) analysis of parasite DNA. PCR detected an additional six patients (two SP and four AL) with sub-microscopic gametocytemia or breakthrough parasitemia between Days 14 and 28, suggesting that AL efficacy was lower than estimated by microscopy. Dhfr and dhps mutations were not associated with outcome. AL is more effective than SP for uncomplicated malaria in Nepal, but regular monitoring of its efficacy should be carried out if this combination therapy is introduced.

Details

Language :
English
ISSN :
0002-9637
Volume :
77
Issue :
3
Database :
MEDLINE
Journal :
The American journal of tropical medicine and hygiene
Publication Type :
Academic Journal
Accession number :
17827354