Efficacy of Artesunate + Sulphadoxine-Pyrimethamine (AS + SP) and Amodiaquine + Sulphadoxine-Pyrimethamine (AQ+ SP) for Uncomplicated falciparum Malaria in Equatorial Guinea (Central Africa)

ABSTRACT

The objectives of the study were (i) to evaluate the efficacy of combination drugs; such as artesunate + sulphadoxinepyrimethamine (AS + SP) and amodiaquine + sulphadoxine-pyripethamine (AQ+ SP) in treatment of uncomplicated falciparum malaria (ii) to differentiate recrudescence from reinfection by analysing msp-1 and msp-2 genes of Plasmodium falciparum in treatment failure cases. Methods. We carried out an in vivo study in the year 2005 in 206 children between 6 to 59 months age groups. Of the 206; 120 received AQ+ SP; and 86 received AS + SP. A clinical and parasitological followup during 14 days was undertaken. Finger-prick blood sample from each patient was taken onWhatman filter paper (no. 3) on days 0; 7; 14 and also the day when the parasite and symptoms reappeared for PCR analysis. Results. Late treatment failure was observed in 3.5(4/114) with AQ+ SP; and 2.5(2/79) with AS + SP. The success rate was 96.5with AQ+ SP and 97.5with AS + SP. No deaths and severe reactions were recorded. Out of the 6 treatment failure cases; one was reinfection as observed by PCR analysis of msp-1 and msp-2 genes on day 14. Discussion. Both the combinations found to be efficacious and safe and could be used as a first-line treatment for uncomplicated falciparum malaria in Equatorial Guinea