Treatment of uncomplicated malaria in children in Guinea-Bissau with chloroquine, quinine, and sulfadoxine-pyrimethamine

被引:15
作者
Kofoed, PE [1 ]
Có, F
Johansson, P
Dias, F
Cabral, C
Hedegaard, K
Aaby, P
Rombo, L
机构
[1] Kolding Cty Hosp, Dept Paediat, DK-6000 Kolding, Denmark
[2] Statens Serum Inst, Danish Epidemiol Sci Ctr, Dept Epidemiol Res, Copenhagen, Denmark
[3] Lab Nacl Saude Publ, Bissau, Guinea Bissau
[4] Malarsjukhuset, Div Infect Dis Thorac Med & Dermatol, Eskilstuna, Sweden
关键词
malaria; Plasmodium falciparum; chemotherapy; children; chloroquine; quinine; sulfadoxine-pyrimethamine; Guinea-Bissau;
D O I
10.1016/S0035-9203(02)90107-0
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
With the increasing resistance to commonly used antimalarial drugs, different untested 'local' treatment regimens for malaria will arise. We compared commonly used treatment regimens for children in Guinea-Bissau. Symptomatic children with Plasmodium falciparum mono-infection were allocated at random to one of 4 treatments: 15 mg/kg quinine twice a day for 3 d (group 1); 10 mg/kg quinine twice a day for 3 d followed by a total dose of 25 mg chloroquine base given over 3 d (group 2); a total dose of 50 mg/kg chloroquine base given in 2 daily doses for 3 d (group 3), or sulfadoxine-pyrimethamine (group 4). On day 28 more children from group 1 (33%; relative risk [RR] = 2-9, 95% confidence interval [CI] 1.5-5.7) and group 2 (26%; RR = 2.1, Cl 1.0-4.3) had had parasitaemia than in group 4 (12%), whereas no significant difference was found between group 3 (17%; RR = 1.3, CI 0-6-2-2) and group 4. No severe adverse reaction was observed in any of the groups. Chloroquine is still effective in Guinea-Bissau at an increased dose of 50 mg/kg, which appears safe when given orally in 2 daily doses for 3 d. Sulfadoxine-pyrimethamine could serve as an efficient, cheap and easy to administer second-line drug, leaving quinine to be used for third-line treatment. Quinine should not be used in short courses, nor does the combination of quinine and chloroquine have any advantage.
引用
收藏
页码:304 / 309
页数:6
相关论文
共 28 条
[1]  
ADAGU SI, 1995, J TROP MED HYG, V98, P296
[2]  
[Anonymous], TISSUE ENG VASCULAR
[3]   ESTIMATION OF THE PROPORTIONAL HAZARD IN 2-TREATMENT-GROUP CLINICAL-TRIALS [J].
BERNSTEIN, L ;
ANDERSON, J ;
PIKE, MC .
BIOMETRICS, 1981, 37 (03) :513-519
[4]   A trial of Fansidar® plus chloroquine or Fansidar® alone for the treatment of uncomplicated malaria in Gambian children [J].
Bojang, KA ;
Schneider, G ;
Forck, S ;
Obaro, SK ;
Jaffar, S ;
Pinder, M ;
Rowley, J ;
Greenwood, BM .
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 1998, 92 (01) :73-76
[5]  
COOSEMANS MH, 1985, B WORLD HEALTH ORGAN, V63, P331
[6]   A RANDOMIZED CLINICAL-TRIAL WITH HIGH-DOSE OF CHLOROQUINE FOR TREATMENT OF PLASMODIUM-FALCIPARUM MALARIA IN BRAZIL [J].
DEANDRADE, JG ;
DEANDRADE, ALSS ;
ARAUJO, ESO ;
OLIVEIRA, RM ;
SILVA, SA ;
MARTELLI, CMT ;
ZICKER, F .
REVISTA DO INSTITUTO DE MEDICINA TROPICAL DE SAO PAULO, 1992, 34 (05) :467-473
[7]  
Falaschi F, 1997, E AFR MED J, V74, P275
[8]  
FOSTER SD, 1991, B WORLD HEALTH ORGAN, V69, P349
[9]  
Gaye O, 1997, Med Trop (Mars), V57, P47
[10]   Cost-effectiveness of malaria control in sub-Saharan Africa [J].
Goodman, CA ;
Coleman, PG ;
Mills, AJ .
LANCET, 1999, 354 (9176) :378-385