Safety and efficacy of dihydroartemisinin-piperaquine versus artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Zambian children
Abstract
Background: Malaria in Zambia remains a public health and developmental challenge, affecting mostly children under five and pregnant women. In 2002, the first-line treatment for uncomplicated malaria was changed to artemether-lumefantrine (AL), which has proved to be highly efficacious against multidrug-resistant Plasmodium falciparum. Objective: The study objective was to determine whether dihydroartemisinin-piperaquine (DHA/PQP) had similar efficacy, safety and tolerability to AL for the treatment of children with uncomplicated P. falciparum malaria in Ndola, Zambia. Methods: Between 2005 and 2006, 304 children (6-59 months old) with uncomplicated P. falciparum infection were enrolled, randomized to AL (101) or DHA/PQP (203) and followed up for 42 days. Outcome of treatment was defined according to the standard WHO classification, i.e. early treatment failure (ETF), late clinical failure (LCF), late parasitological failure (LPF) and adequate clinical and parasitological response (ACPR). Recurrent infections were genotyped to distinguish between recrudescence and new infection. Results: No ETF was observed. At day 28, PCR-uncorrected ACPR was 92% in the DHA/PQP and 74% in the AL arm (OR: 4.05; 95%CI: 1.89-8.74; p
Citation
Chaponda, M.; D’Alessandro, U.; van Geertruyden, J.P.; Hachizovu, S.; Mukwamataba, D.; Mulenga, M.; Nambozi, M.; Ubben, D. Safety and efficacy of dihydroartemisinin-piperaquine versus artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Zambian children. Malaria Journal (2011) 10: 50. [DOI: 10.1186/1475-2875-10-50]