Artesunate-amodiaquine efficacy in Congolese children with acute uncomplicated falciparum malaria in Brazzaville
Tóm tắt
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. 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. 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. 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.
Tài liệu tham khảo
World Health Organization: World malaria report 2009. 2009, Geneva: WHO
World Health Organization: World malaria report 2010. 2010, Geneva: WHO
Trape JF, Pison G, Preziosi MP, Enel C, Desgrées du Loû A, Delaunay V, Samba B, Lagarde E, Molez JF, Simondon F: Impact of chloroquine resistance on malaria mortality. CR Acad Sci III. 1998, 321: 689-697. 10.1016/S0764-4469(98)80009-7.
Trape JF: The public health impact of chloroquine resistance in Africa. Am J Trop Med Hyg. 2001, 64 (1–2 suppl): 12-17.
Zucker JR, Ruebush TK, Obonyo C, Otieno J, Campbell CC: The mortality consequences of the continued use of chloroquine in Africa: experience in Siaya, western Kenya. Am J Trop Med Hyg. 2003, 68: 386-390.
Björkman A, Bhattarai A: Public health impact of drug resistant Plasmodium falciparum malaria. Acta Trop. 2005, 94: 163-169. 10.1016/j.actatropica.2005.04.015.
Ashley EA, White NJ: Artemisinin-based combinations. Curr Opin Infect Dis. 2005, 18: 531-536. 10.1097/01.qco.0000186848.46417.6c.
Whitty CJ, Chandler C, Ansah E, Leslie T, Staedke SG: Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities. Malar J. 2008, 7 (suppl 1): S7-10.1186/1475-2875-7-S1-S7.
World Health Organization: Antimalarial drug combination therapy. Report of a WHO technical consultation. 2001, Geneva: WHO
World Health Organization: The African Malaria report. 2006, Geneva: WHO
Ministère de la Santé et de la Population, République du Congo: Politique nationale de lutte contre le paludisme. 2006, Brazzaville: Ministry of Health and Population
Richard A, Lallemant M, Trape JF, Carnevale P, Mouchet J: [Malaria in the forest region of Mayombe, People's Republic of the Congo. III. The role of malaria in general morbidity](in French). Ann Soc Belge Méd Trop. 1988, 68: 317-329.
Ndounga M, Casimiro PN, Miakassissa-Mpassi V, Loumouamou D, Ntoumi F, Basco LK: [Malaria in health centres in the southern districts of Brazzaville, Congo](in French). Bull Soc Pathol Exot. 2008, 101: 329-335. 10.3185/pathexo3111.
Moyen G, Nzingoula S, Mowandza-Ndinga JC, Nkoua JL, Mpemba AB, Fourcarde V: Le paludisme de l'enfant dans un service de pédiatrie à Brazzaville. A propos de 1073 observations. Med Afr Noire. 1993, 40: 177-181.
Miakoundoba RC, Mabiala-Babela JR, Senga P: Morbidité et mortalité des enfants de 1 à 4 ans au CHU de Brazzaville-Congo. Med Afr Noire. 2008, 55: 300-304.
Mabiala-Babela JR, Makoumbou PB, Mbika-Cardorelle A, Tsiba JB, Senga P: Congo-Brazzaville: Evolution de la mortalité hospitalière chez l’enfant à Brazzaville (Congo). Med Afr Noire. 2009, 56: 5-8.
Nsimba B, Malonga DA, Mouata AM, Louya F, Kiori J, Malanda M, Yocka D, Oko-Ossho J, Ebata-Mongo S, Le Bras J: Efficacy of sulfadoxine/pyrimethamine in the treatment of uncomplicated Plasmodium falciparum malaria in Republic of Congo. Am J Trop Med Hyg. 2004, 70: 133-138.
Mayengue PI, Ndounga M, Matondo Maya D, Ntandou N, Ntoumi F: In vivo chloroquine resistance of the pfcrt codon 76 mutation in Plasmodium falciparum isolates from the Republic of Congo. Acta Trop. 2005, 95: 219-225. 10.1016/j.actatropica.2005.06.001.
Ndounga M, Mayengue PI, Tahar R, Casimiro PN, Matondo Maya DW, Miakassissa-Mpassi V, Malonga DA, Nsonde Ntandou F, Mallanda G, Ringwald P, Basco LK, Ntoumi F: Efficacy of sulfadoxine-pyrimethamine, amodiaquine, and sulfadoxine-pyrimethamine-amodiaquine combination for the treatment of uncomplicated falciparum malaria in the urban and suburban areas of Brazzaville (Congo). Acta Trop. 2007, 103: 163-171. 10.1016/j.actatropica.2007.06.002.
Nsimba B, Jafari-Guemouri S, Malonga DA, Mouata AM, Kiori J, Louya F, Yocka D, Malanda M, Durand R, Le Bras J: Epidemiology of drug-resistant malaria in Republic of Congo: using molecular evidence for monitoring antimalarial drug resistance combined with assessment of antimalarial drug use. Trop Med Int Health. 2005, 10: 1030-1037. 10.1111/j.1365-3156.2005.01490.x.
Ndounga M, Tahar R, Basco LK, Casimiro PN, Malonga DA, Ntoumi F: Therapeutic efficacy of sulfadoxine-pyrimethamine and the prevalence of molecular markers of resistance in under-five year olds in Brazzaville, Congo. Trop Med Int Health. 2007, 12: 1164-1171. 10.1111/j.1365-3156.2007.01904.x.
van den Broek I, Kitz C, Al Attas S, Libama F, Balasegaram M, Guthmann JP: Efficacy of three artemisinin combination therapies for the treatment of uncomplicated Plasmodium falciparum malaria in the Republic of Congo. Malar J. 2006, 5: 113-10.1186/1475-2875-5-113.
Centre National de la Statistique et des Etudes Economiques (CNSEE), République du Congo: Le Recensement Général de la Population et d l’Habitat (RGPH) – 2007 en quelques chiffres. 2007, Brazzaville: Republic of Congo
Trape JF, Nzoulany A: Malaria and urbanization in central Africa: the example of Brazzaville. Part II: Results of entomological surveys and epidemiological analysis. Trans R Soc Trop Med Hyg. 1987, 81 (suppl 2): 10-18.
Trape JF, Nzoulany A: Malaria and urbanization in central Africa: the example of Brazzaville. Part III: Relationships between urbanization and the intensity of malaria transmission. Trans R Soc Trop Med Hyg. 1987, 81 (suppl 2): 19-25.
World Health Organization: Assessment and monitoring of antimalarial drug efficacy for the treatment of uncomplicated falciparum malaria WHO/RBM/HTM/2003.50. 2003, Geneva: WHO
Mayengue PI, Ndounga M, Malonga FV, Bitemo M, Ntoumi F: Genetic polymorphism of merozoite surface protein-1 and merozoite surface protein-2 in Plasmodium falciparum isolates from Brazzaville, Republic of Congo. Malar J. 2011, 10: 276-10.1186/1475-2875-10-276.
World Health Organization: Methods and techniques for clinical trials on antimalarial drug efficacy: genotyping to identify parasite populations. 2008, Geneva: WHO
Adjuik M, Agnamey P, Babiker A, Borrmann S, Brasseur P, Cisse M, Cobelens F, Diallo S, Faucher JF, Garner P, Gikunda S, Kremsner PG, Krishna S, Lell B, Loolpapit M, Matsiegui PB, Missinou MA, Mwanza J, Ntoumi F, Olliaro P, Osimbo P, Rezbach P, Some E, Taylor WRJ: Amodiaquine-artesunate versus amodiaquine for uncomplicated Plasmodium falciparum malaria in African children: a randomised, multicentre trial. Lancet. 2002, 359: 1365-1372. 10.1016/S0140-6736(02)08348-4.
van den Broek I, Amsalu R, Balasegaram M, Hepple P, Alemu E, El Badri H, Al-Faith M, Montgomery J, Checchi F: Efficacy of two artemisinin combination therapies for uncomplicated falciparum malaria in children under 5 years, Malakal, Upper Nile, Sudan. Malar J. 2005, 4: 14-10.1186/1475-2875-4-14.
Sowunmi A, Fehintola FA, Adedeji AA, Gbotosho GO, Tambo E, Fateye BA, Happi TC, Oduola AMJ: Open randomized study of artesunate-amodiaquine vs. chloroquine-pyrimethamine-sulfadoxine for the treatment of uncomplicated Plasmodium falciparum malaria in Nigerian children. Trop Med Int Health. 2005, 10: 1161-1170. 10.1111/j.1365-3156.2005.01503.x.
Guthmann JP, Cohuet S, Rigutto C, Fortes F, Saraiva N, Kiguli J, Kyomuhendo J, Francis M, Noël F, Mulemba M, Balkan S: High efficacy of two artemisinin-based combinations (artesunate + amodiaquine and artemether + lumefantrine) in Caala, Central Angola. Am J Trop Med Hyg. 2006, 75: 143-145.
Swarthout TD, van den Broek IV, Kayembe G, Montgomery J, Pota H, Roper C: Artesunate + amodiaquine and artesunate + sulphadoxine –pyrimethamine for treatment of uncomplicated malaria in Democratic Republic of Congo: a clinical trial with determination of sulphadoxine and pyrimethamine-resistant haplotypes. Trop Med Int Health. 2006, 11: 1503-1511. 10.1111/j.1365-3156.2006.01710.x.
Bonnet M, van den Broek I, Van Herp M, Urrutia PPP, Van Overmeir C, Kyomuhendo J, Ndosimao CN, Ashley E, Guthmann JP: Varying efficacy of artesunate + amodiaquine and artesunate + sulphadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in the Democratic Republic of Congo: a report of two in-vivo studies. Malar J. 2009, 8: 192-10.1186/1475-2875-8-192.
Oyakhirome S, Pötschke M, Schwarz NG, Dörnemann J, Laengin M, Salazar CO, Lell B, Kun JF, Kremsner PG, Grobusch MP: Artesunate-amodiaquine combination therapy for falciparum malaria in young Gabonese children. Malar J. 2007, 6: 29-10.1186/1475-2875-6-29.
Koram KA, Quate L, Abuaku B: Efficacy of amodiaquine/artesunate combination therapy for uncomplicated malaria in children under five years in Ghana. Ghana Med J. 2008, 42: 55-60.
Kobbe R, Klein P, Adjei S, Amemasor S, Thompson WN, Heidemann H, Nielsen MV, Vohwinkel J, Hogan B, Kreuels B, Bührlen M, Loag W, Ansong D, May J: A randomized trial on effectiveness of artemether-lumefantrine versus artesunate plus amodiaquine for unsupervised treatment of uncomplicated Plasmodium falciparum malaria in Ghanaian children. Malar J. 2008, 7: 261-10.1186/1475-2875-7-261.