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Artesunate-amodiaquine efficacy in Congolese children with acute uncomplicated falciparum malaria in Brazzaville

Mathieu Ndounga1*, Pembe Issamou Mayengue23, Prisca Nadine Casimiro1, Dieudonné Loumouamou4, Leonardo K Basco56, Francine Ntoumi23 and Philippe Brasseur7

Author Affiliations

1 Unité de Recherche sur le Paludisme, Centre d’Etudes sur les Ressources Végétales (CERVE), Brazzaville BP 1249, République du Congo

2 Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, BP 2672, République du Congo

3 Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, BP 2672, République du Congo

4 Circonscription Socio-Sanitaire de Makélékélé, Ministère de la Santé, Brazzaville, République du Congo

5 Institut de Recherche pour le Développement (IRD), Unité Mixte de Recherche 198, Unité de Recherche des Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine La Timone, Université Aix-Marseille, Marseille, France

6 Laboratoire de Recherches sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon

7 Institut de Recherche pour le Développement (IRD) Unité mixte de Recherche 198, Dakar, BP 1386, Sénégal

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Malaria Journal 2013, 12:53  doi:10.1186/1475-2875-12-53

Published: 5 February 2013

Abstract

Background

Congo-Brazzaville adopted artemisinin-based combination therapy (ACT) in 2006. Artesunate-amodiaquine (AS + AQ) and artemether-lumefantrine are the first-line and second-line anti-malarial drugs to treat uncomplicated Plasmodium falciparum malaria, respectively. The baseline efficacy of AS + AQ was evaluated from February to August 2005 in patients living in Brazzaville, the capital city of the Republic of Congo.

Methods

One hundred and ninety-seven patients (96 ≤5 years old and 101 >5 years old, including adults) were recruited in a non-randomized study, treated under supervision with AS + AQ, and were followed up for 28 days in accordance with the 2003 World Health Organization protocol. Plasmodium falciparum recrudescent isolates from day 7 to day 28 were compared to pretreatment isolates by polymerase chain reaction (PCR) to distinguish between re-infection and recrudescence.

Results

The overall efficacy of AS + AQ after PCR correction on day 28 was 94.4%. An adequate clinical and parasitological response was observed in 94.3% and 94.4% of children aged ≤5 years old and those aged >5 years old (including adults), respectively. The main reported adverse events were dizziness, vomiting, diarrhoea, pruritus, headache, anorexia, and abdominal pain.

Conclusion

This study has shown the high efficacy of AS + AQ in Congolese patients of all ages with acute uncomplicated falciparum malaria and serves as the baseline efficacy and tolerance of this ACT in Brazzaville.

Keywords:
Drug resistance; Artemisinin; Combination therapy; Chloroquine; Drug efficacy; Congo-Brazzaville