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Sulfadoxine–pyrimethamine plus artesunate compared with chloroquine for the treatment of vivax malaria in areas co-endemic for Plasmodium falciparum and P. vivax: a randomised non-inferiority trial in eastern Afghanistan
- Source :
- Transactions of the Royal Society of Tropical Medicine & Hygiene; Nov2007, Vol. 101 Issue 11, p1081-1087, 7p
- Publication Year :
- 2007
-
Abstract
- Summary: Chloroquine (CQ) is an effective treatment of choice for vivax malaria in most settings, but with the spread of CQ-resistant Plasmodium falciparum, many countries now use artemisinin-based combination therapy for treatment of falciparum malaria. In areas co-endemic for falciparum and vivax malaria incorrect differential diagnosis is always a risk. In Afghanistan the adoption of sulfadoxine–pyrimethamine plus artesunate (SP+AS) as first-line falciparum treatment raises the prospect of a significant proportion of vivax malaria being misdiagnosed and treated with the combination. SP is considered to have limited efficacy against vivax malaria, and the efficacy of SP+AS against Plasmodium vivax has not been established in areas that are using SP+AS. A randomised, non-inferiority trial comparing SP+AS with CQ monotherapy was undertaken on 190 vivax malaria patients in eastern Afghanistan. Standard WHO procedures for in vivo evaluation of antimalarial drugs were followed. A total of 180 individuals completed the trial to day 42. Using a per protocol analysis, both regimens resulted in ≥96% treatment success at 28 d, but significantly more cases failed in the CQ arm (46%) than in the SP+AS arm (24%) by day 42. In areas where vivax infections might be misdiagnosed as falciparum infections and treated with SP+AS, patient management would be as good, or better than, with the standard CQ treatment [ClinicalTrials.gov Registration No. NCT00486694]. [Copyright &y& Elsevier]
- Subjects :
- MALARIA
AVIAN malaria
BLACKWATER fever
CEREBRAL malaria
Subjects
Details
- Language :
- English
- ISSN :
- 00359203
- Volume :
- 101
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Transactions of the Royal Society of Tropical Medicine & Hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 26840182
- Full Text :
- https://doi.org/10.1016/j.trstmh.2007.06.015