Continued efficacy of sulfadoxine-pyrimethamine as second line treatment for malaria in children in Guinea-Bissau

Poul-Erik Kofoed, Amabelia Rodrigues, Peter Aaby, Lars Rombo

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Udgivelsesdato: Dec
OriginalsprogEngelsk
TidsskriftActa Tropica
Vol/bind100
Udgave nummer3
Sider (fra-til)213-217
Antal sider4
ISSN0001-706X
DOI
StatusUdgivet - 1. dec. 2006

Fingeraftryk

Guinea-Bissau
Malaria
Treatment Failure
Quinine
Chloroquine
Plasmodium falciparum
Genetic Markers
Pharmaceutical Preparations
pyrimethamine drug combination fanasil
Polymerase Chain Reaction

Citer dette

Kofoed, Poul-Erik ; Rodrigues, Amabelia ; Aaby, Peter ; Rombo, Lars. / Continued efficacy of sulfadoxine-pyrimethamine as second line treatment for malaria in children in Guinea-Bissau. I: Acta Tropica. 2006 ; Bind 100, Nr. 3. s. 213-217.
@article{03b6a0f0693011ddb1a1000ea68e967b,
title = "Continued efficacy of sulfadoxine-pyrimethamine as second line treatment for malaria in children in Guinea-Bissau",
abstract = "BACKGROUND: Sulfadoxine-pyrimethamine (S/P) is widely used for treatment of failures following the first line treatment for malaria in Africa. In Guinea-Bissau, it has been recommended as second line therapy by the National Malaria Programme since 1996. In order to monitor any change of the in vivo sensitivity, the efficacy of S/P was studied immediately before the introduction of the drug and 6-9 years later. METHODS: Children participating in clinical in vivo studies were given S/P if having late clinical treatment failure following the treatment with quinine, chloroquine, or amodiaquine. Parasitological and clinical failures were evaluated during a 35-day follow-up. During the first study period whole blood sulfadoxine concentrations were measured on day 7. RESULTS: Altogether, 56 children failed the initial treatment and were included in 1995/1996 as well as 55 children in 2002/2004. The PCR-uncorrected adequate clinical and parasitological response rates on day 28 were 94{\%} and 91{\%}, and on day 35 they were 89{\%} and 91{\%}, respectively, in the two periods. No difference between median blood drug concentration in children with and without treatment failure was observed. INTERPRETATION: The efficacy of S/P as second line treatment for uncomplicated malaria has remained unchanged in spite of a relatively high level of genetic markers associated with Plasmodium falciparum resistance to S/P previously found in the area.",
keywords = "Adolescent, Animals, Antimalarials, Child, Child, Preschool, Drug Combinations, Female, Guinea-Bissau, Humans, Infant, Malaria, Falciparum, Male, Parasitemia, Plasmodium falciparum, Pyrimethamine, Sulfadoxine, Tablets, Treatment Failure, Urban Population",
author = "Poul-Erik Kofoed and Amabelia Rodrigues and Peter Aaby and Lars Rombo",
year = "2006",
month = "12",
day = "1",
doi = "10.1016/j.actatropica.2006.09.014",
language = "English",
volume = "100",
pages = "213--217",
journal = "Acta Tropica",
issn = "0001-706X",
publisher = "Elsevier",
number = "3",

}

Continued efficacy of sulfadoxine-pyrimethamine as second line treatment for malaria in children in Guinea-Bissau. / Kofoed, Poul-Erik; Rodrigues, Amabelia; Aaby, Peter; Rombo, Lars.

I: Acta Tropica, Bind 100, Nr. 3, 01.12.2006, s. 213-217.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Continued efficacy of sulfadoxine-pyrimethamine as second line treatment for malaria in children in Guinea-Bissau

AU - Kofoed, Poul-Erik

AU - Rodrigues, Amabelia

AU - Aaby, Peter

AU - Rombo, Lars

PY - 2006/12/1

Y1 - 2006/12/1

N2 - BACKGROUND: Sulfadoxine-pyrimethamine (S/P) is widely used for treatment of failures following the first line treatment for malaria in Africa. In Guinea-Bissau, it has been recommended as second line therapy by the National Malaria Programme since 1996. In order to monitor any change of the in vivo sensitivity, the efficacy of S/P was studied immediately before the introduction of the drug and 6-9 years later. METHODS: Children participating in clinical in vivo studies were given S/P if having late clinical treatment failure following the treatment with quinine, chloroquine, or amodiaquine. Parasitological and clinical failures were evaluated during a 35-day follow-up. During the first study period whole blood sulfadoxine concentrations were measured on day 7. RESULTS: Altogether, 56 children failed the initial treatment and were included in 1995/1996 as well as 55 children in 2002/2004. The PCR-uncorrected adequate clinical and parasitological response rates on day 28 were 94% and 91%, and on day 35 they were 89% and 91%, respectively, in the two periods. No difference between median blood drug concentration in children with and without treatment failure was observed. INTERPRETATION: The efficacy of S/P as second line treatment for uncomplicated malaria has remained unchanged in spite of a relatively high level of genetic markers associated with Plasmodium falciparum resistance to S/P previously found in the area.

AB - BACKGROUND: Sulfadoxine-pyrimethamine (S/P) is widely used for treatment of failures following the first line treatment for malaria in Africa. In Guinea-Bissau, it has been recommended as second line therapy by the National Malaria Programme since 1996. In order to monitor any change of the in vivo sensitivity, the efficacy of S/P was studied immediately before the introduction of the drug and 6-9 years later. METHODS: Children participating in clinical in vivo studies were given S/P if having late clinical treatment failure following the treatment with quinine, chloroquine, or amodiaquine. Parasitological and clinical failures were evaluated during a 35-day follow-up. During the first study period whole blood sulfadoxine concentrations were measured on day 7. RESULTS: Altogether, 56 children failed the initial treatment and were included in 1995/1996 as well as 55 children in 2002/2004. The PCR-uncorrected adequate clinical and parasitological response rates on day 28 were 94% and 91%, and on day 35 they were 89% and 91%, respectively, in the two periods. No difference between median blood drug concentration in children with and without treatment failure was observed. INTERPRETATION: The efficacy of S/P as second line treatment for uncomplicated malaria has remained unchanged in spite of a relatively high level of genetic markers associated with Plasmodium falciparum resistance to S/P previously found in the area.

KW - Adolescent

KW - Animals

KW - Antimalarials

KW - Child

KW - Child, Preschool

KW - Drug Combinations

KW - Female

KW - Guinea-Bissau

KW - Humans

KW - Infant

KW - Malaria, Falciparum

KW - Male

KW - Parasitemia

KW - Plasmodium falciparum

KW - Pyrimethamine

KW - Sulfadoxine

KW - Tablets

KW - Treatment Failure

KW - Urban Population

U2 - 10.1016/j.actatropica.2006.09.014

DO - 10.1016/j.actatropica.2006.09.014

M3 - Journal article

VL - 100

SP - 213

EP - 217

JO - Acta Tropica

JF - Acta Tropica

SN - 0001-706X

IS - 3

ER -