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Biomedicines 2016, 4(1), 5; doi:10.3390/biomedicines4010005

In Vivo Efficacy of Artesunate/Sulphadoxine-Pyrimethamine versus Artesunate/Amodiaquine in the Treatment of Uncomplicated P. falciparium Malaria in Children around the Slope of Mount Cameroon: A Randomized Controlled Trial

1
Department of Biochemistry and Molecular Biology, University of Buea, PO Box 63 Buea, Cameroon
2
Department of Zoology and Animal Physiology, University of Buea, PO Box 63 Buea, Cameroon
3
School of Applied Sciences, Saint Monica University, PO Box 132 Buea, Cameroon
4
Department of Animal Biology and Physiology, University of Yaounde I, PO Box 8094 Yaounde, Cameroon
5
Department of Medical Laboratory Science, University of Buea, PO Box 63 Buea, Cameroon
*
Author to whom correspondence should be addressed.
Academic Editor: N. Manjunath
Received: 9 November 2015 / Revised: 31 January 2016 / Accepted: 4 February 2016 / Published: 15 February 2016
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Abstract

Background: The development and spread of antimalarial drug resistant parasites contributes to the global impact of the disease. In vivo efficacy assessments of treatments for Plasmodium falciparum malaria are essential for ensuring effective case management. Artemisinin-based combinations have been adopted as the first-line treatment for uncomplicated P. falciparum malaria in Cameroon since 2004. Methods: A total of 177 children aged six-months to 10 years with uncomplicated mono-infected falciparum malaria were randomized (1:1) to receive artesunate/sulphadoxine-pyrimethamine (AS/SP) or artesunate/amodiaquine (AS/AQ) pediatric tablets and followed up for 28 days according to the standard World Health Organization in vivo drug efficacy monitoring protocol. The primary and secondary endpoints were PCR uncorrected and corrected cure rates, as measured by adequate clinical and parasitological response (ACPR) on day 28. Results: The PCR corrected cure rate was high, overall (88.1%, 95% CI 83.1–93.1), 85.9% (95% CI 78.2–93.6), and 90.2% (95% CI 83.8–96.6) for AS/SP and AS/AQ, respectively. Twenty-one treatment failures were observed during follow-up, constituting one (4.6%), 14 (8.2%), and six (3.5%) early treatment failure (ETF), late clinical failure (LCF), and late parasitological failure (LPF), respectively. The drugs were well tolerated with no serious adverse events. Conclusions: Both AS/SP and AS/AQ are highly effective and well-tolerated treatments for uncomplicated P. falciparum malaria around the slope of Mount Cameroon. View Full-Text
Keywords: in vivo efficacy; ACT (artemisinin–based combination therapy); uncomplicated Plasmodium falciparum in vivo efficacy; ACT (artemisinin–based combination therapy); uncomplicated Plasmodium falciparum
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Apinjoh, T.O.; Anchang-Kimbi, J.K.; Ajonina, M.U.; Njonguo, E.T.; Njua-Yafi, C.; Ngwai, A.N.; Mugri, R.N.; Achidi, E.A. In Vivo Efficacy of Artesunate/Sulphadoxine-Pyrimethamine versus Artesunate/Amodiaquine in the Treatment of Uncomplicated P. falciparium Malaria in Children around the Slope of Mount Cameroon: A Randomized Controlled Trial. Biomedicines 2016, 4, 5.

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