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In an open, randomized, clinical trial, conducted in New Halfa, eastern Sudan, in September–October 2004, the efficacies and adverse effects of artesunate plus sulfadoxine–pyrimethamine (SP), in the treatment of uncomplicated, Plasmodium falciparum malaria, were compared with those of SP alone. Patients were randomized to receive either artesunate (4 mg/kg. day) on days 0–2 plus SP (25 mg sulfadoxine/kg) on day 0 or the SP alone, and then followed-up for 28 days. Sixty patients completed follow-up. Compared with the 30 given artesunate plus SP (ASP), the 30 given SP alone were much more likely to be febrile (30% v. 3.3%; P=0.006) and parasitaemic (50% v. 6.7%; P<00001) on day 1. By day 3, 16.7% of the patients given SP alone were still febrile and 6.7% of them were still parasitaemic, although all the patients given ASP were then afebrile (P=0.02) and aparasitaemic (P=0.1). Five (16.7%) of the patients treated with SP alone but none of those given ASP appeared to be treatment failures (P<0.05). Parasite genotyping revealed that four of the five apparent treatment failures were true recrudescences but the other represented a re-infection detected on day 28. The true frequencies of cure by day 28 were therefore 100% for ASP and 86.7% for SP alone (P=0.02). Adverse effects of treatment (nausea, itching and giddiness) were observed with similar frequencies in the two treatment arms (10.0% of the patients given ASP v. 13.3% of the patients given SP alone; P>0.05). The frequencies of gametocytaemia during follow-up were, however, much lower in the ASP arm than in the SP-only (0.0% v. 23.3%; P=0.005). Thus, although the problems posed by adverse effects were similar in the two treatment arms, ASP appeared markedly better, in terms of fever- and parasite-clearance times and the prevalence of post-treatment gametocytaemia, than SP alone. [ABSTRACT FROM AUTHOR]

The clinical and serological responses to attenuated measles virus vaccine were compared in 35 severely malnourished and 35 well-nourished children. A third group of severely malnourished children, who received an injection of vitamin B12, served as controls. The children were observed for three weeks following vaccination. Paired sera were collected from each child before and after administration of the vaccine or vitamin B12 and measles antibody titres were estimated using HAI technique. The malnourished children who received measles vaccine developed higher fever of longer duration and had more lower respiratory tract disease than the other two groups but had fewer skin rashes than the well-nourished group. Sero-conversion rates were 96% had 92.6% in the malnourished and well-nourished vaccinated children, respectively. Antibody titres were lower in children who had marasmic/kwashiorkor than in the marasmic children.