Author:
Ndong Ngomo Jacques M.,Ondzagha Megnie Guy J.,Moutombi Ditombi Bridy,Koumba Lengongo Jeanne V.,M’Bondoukwé Noé P.,Offouga Christelle L.,Mawili-Mboumba Denise P.,Lekana-Douki Jean B.,Ringwald Pascal,Fandeur Thierry,Bouyou-Akotet Marielle K.
Abstract
Abstract
Purpose
Artesunate–amodiaquine (AS–AQ) and artemether–lumefantrine (AL) have been widely used for the treatment of uncomplicated Plasmodium falciparum malaria since 2005 in Gabon. Since 2011, a rebound of malaria morbidity has been observed in this country, while no survey evaluating ACT efficacy was performed. During the same period, parasite resistance against artemisinin has been reported in Asia. The aim of this study was to assess the efficacy and tolerability of these two drugs in two sentinel sites of Gabon 10 years after their implementation.
Methods
Children aged from 12 to 144 months with uncomplicated malaria were recruited at the Regional Hospital of Melen, Libreville and in the Urban Health Center of Franceville between March 2014 and September 2015. The therapeutic efficacy was evaluated according to the WHO 2008 protocol of 28-day follow-up and PCR-uncorrected/corrected treatment outcomes were assessed.
Results
One hundred and eighty-five children (98 ASAQ and 89 AL) were followed up until day 28. The PCR-corrected ACPR was 98.9% for AS–AQ and 96.4% for AL. Late therapeutic failure rate was 3.6% and 1.1% for AL and AS–AQ, respectively (p = 0.2). Adverse events and serious adverse events were rarely observed with both treatments.
Conclusion
AS–AQ and AL are still efficacious and well-tolerated for the treatment of uncomplicated malaria in Gabonese children.
Reference24 articles.
1. Adjuik M, Agnamey P, Babiker A, Borrmann S, Brasseur P, Cisse M et al (2002) Amodiaquine-artesunate versus amodiaquine for uncomplicated Plasmodium falciparum malaria in African children: a randomised, multicentre trial. Lancet 359:1365–1372.
https://doi.org/10.1016/S0140-6736(02)08348-4
2. Ashley EA, Dhorda M, Fairhurst RM, Amaratunga C, Lim P, Suon S et al (2014) Spread of artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med 371:411–423
3. Bouyou-Akotet MK, Nzenze-Afène S, Mabika-Mafoumbi M, Pemba M, Effame Eya E, Kombila M (2006) Evaluation de l’efficacité et de la toléance de l’Arsucam®, de l’artequin®, et du Coartem® dans le traitement du paludisme non compliqué de l’enfant. Bullin Medical d’Owendo 11:70–75
4. Bouyou-Akotet MK, Offouga CL, Mawili-Mboumba DP, Essola L, Madoungou B, Kombila M et al (2014) Falciparum malaria as an emerging cause of fever in adults living in Gabon, Central Africa. BioMed Res Int.
https://doi.org/10.1155/2014/351281
5. Djallé D, Gody JC, Moyen JM, Tekpa G, Ipero J, Madji N et al (2014) Performance of Paracheck™-Pf, SD Bioline malaria Ag-Pf and SD Bioline malaria Ag-Pf/pan for diagnosis of falciparum malaria in the Central African Republic. BMC Infect Dis 14:109.
https://doi.org/10.1186/1471-2334-14-109