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Similar efficacy and tolerability of double-dose chloroquine and artemether-lumefantrine for treatment of Plasmodium falciparum infection in Guinea-Bissau: a randomized trial
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2011 (English)In: The Journal of infectious diseases, ISSN 1537-6613, Vol. 203, no 1, 109-116 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

In 2008, Guinea-Bissau introduced artemether-lumefantrine for treatment of uncomplicated malaria. Previously, 3 times the standard dose of chloroquine, that was probably efficacious against Plasmodium falciparum with the resistance-associated chloroquine-resistance transporter (pfcrt) 76T allele, was routinely used. The present study compared the efficacy and tolerability of a double standard dose of chloroquine with the efficacy and tolerability of artemether-lumefantrine.

METHODS:

In a randomized open-label clinical trial, artemether-lumefantrine or chloroquine (50 mg/kg) were given as 6 divided doses over 3 days to children aged 6 months - 15 years who had uncomplicated P. falciparum monoinfection. Drug concentrations were measured on day 7. P. falciparum multidrug resistance gene N86Y and pfcrt K76T alleles were identified.

RESULTS:

The polymerase chain reaction-adjusted day 28 and 42 treatment efficacies were 162 (97%) of 168 and 155 (97%) of 161, respectively, for artemether-lumefantrine and 150 (95%) of 158 and 138 (94%) of 148, respectively, for chloroquine. When parasites with resistance-associated pfcrt 76T were treated, the day 28 efficacy of chloroquine was 87%. No severe drug-related adverse events were detected. Symptom resolution was similar with both treatments.

CONCLUSIONS:

Both treatments achieved the World Health Organization-recommended efficacy for antimalarials that will be adopted as policy. High-dose chloroquine treatment regimes should be further evaluated with the aim of assessing chloroquine as a potential partner drug to artemisinin derivatives.

CLINICAL TRIALS REGISTRATION:

NCT00426439

Place, publisher, year, edition, pages
2011. Vol. 203, no 1, 109-116 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-197821DOI: 10.1093/infdis/jiq001PubMedID: 21148503OAI: oai:DiVA.org:uu-197821DiVA: diva2:614385
Available from: 2013-04-04 Created: 2013-04-04 Last updated: 2013-04-05Bibliographically approved

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