EFFICACY OF AMODIAQUINE ALONE AND COMBINED WITH SULFADOXINE-PYRIMETHAMINE AND OF SULFADOXINE PYRIMETHAMINE COMBINED WITH ARTESUNATE

The safety and the efficacy of amodiaquine (AQ) alone, AQ plus sulfadoxine-pyrimethamine (SP) (AQ plusSP), and artes unate (ART) plusSP (ART plusSP), three pos s altern ativesto chloroquine (CQ), were inves - tigated in 379 Rwandan children 6−59 monthsold with uncomplicated Plasmodium falciparum malaria who visited one urban/peri-urban health center and two rural health centers. The three treatment regimenswere well tolerated and no serious adverse effects were observed. Children treated with AQ plus SP had lessclinical failuresthan those treated with ART plusSP (oddsratio (OR) 0.25, 95% confidence interval (CI) 0.06−0.81, P 0.01) or AQ alone (OR 0.33, 95% CI 0.07−1.10, P 0.08). Even after new infectionswere excluded, AQ plusSP wass till s icantly more efficaciousthan ART plusSP ( P 0.05). At day 14, the mean packed cell volume wass ignificantly higher in th eA Q plusSP group compared with the ART plusSP group ( P 0.02) and with the AQ alone group (P 0.01). In Rwanda, AQ plusSP hasbeen chosen to replace CQ asa first-line treatment. However, this is considered an interim measure and new combinations, possibly co-formulated, should be identified and tested.