Artesunate – amodiaquine combination therapy for falciparum malaria in young Gabonese children

Sunny Oyakhirome¹ , Marc Pötschke¹ , Norbert G Schwarz¹ , Jenny Dörnemann¹ , Matthias Laengin¹ , Carmen Ospina Salazar¹ , Bertrand Lell¹^,2 , Jürgen FJ Kun² , Peter G Kremsner¹^,2 and Martin P Grobusch¹^,3

¹Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon

²Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany

³Infectious Diseases Unit, Division of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Malaria Journal 2007, 6:29doi:10.1186/1475-2875-6-29


Published:	12 March 2007

Abstract

Background

Artesunate-amodiaquine combination for the treatment of childhood malaria is one of the artemisinin combination therapies (ACTs) recommended by National authorities in many African countries today. Effectiveness data on this combination in young children is scarce.

Methods

The effectiveness of three daily doses of artesunate plus amodiaquine combination given unsupervised (n = 32), compared with the efficacy when given under full supervision (n = 29) to children with falciparum malaria were assessed in an unrandomized study.

Results

61 patients analysed revealed a PCR-corrected day-28 cure rate of 86 % (25 of 29 patients; CI 69 – 95 %) in the supervised group and 63 % (20 of 32 patients; CI 45 – 77 %) in the unsupervised group. The difference in outcome between both groups was statistically significant (p = 0.04). No severe adverse events were reported.

Conclusion

The effectiveness of this short course regimen in young children with falciparum malaria could be augmented by increased adherence and improved formulation.