Plowe Christopher V, Kublin James G, Dzinjalamala Fraction K, Kamwendo Deborah S, Mukadam Rabia A G, Chimpeni Phillips, Molyneux Malcolm E, Taylor Terrie E
Malaria Section, Center for Vaccine Development, University of Maryland School of Medicine, 685 West Baltimore Street, HSF1-480, Baltimore, MD 21044, USA.
BMJ. 2004 Mar 6;328(7439):545. doi: 10.1136/bmj.37977.653750.EE. Epub 2004 Feb 2.
To measure the efficacy of sulfadoxine-pyrimethamine treatment of falciparum malaria in Malawi from 1998 to 2002, after a change from chloroquine to sulfadoxine-pyrimethamine as first line treatment in that country in 1993.
Prospective open label drug efficacy study.
Health centre in large peri-urban township adjacent to Blantyre, Malawi.
People presenting to a health centre with uncomplicated Plasmodium falciparum malaria.
Therapeutic efficacy and parasitological resistance to standard sulfadoxine-pyrimethamine treatment at 14 days and 28 days of follow up.
Therapeutic efficacy remained stable, with adequate clinical response rates of 80% or higher throughout the five years of the study. Analysis of follow up to 28 days showed modest but significant trends towards diminishing clinical and parasitological efficacy over time within the study period.
Contrary to expectations, sulfadoxine-pyrimethamine has retained good efficacy after 10 years as the first line antimalarial drug in Malawi. African countries with very low chloroquine efficacy, high sulfadoxine-pyrimethamine efficacy, and no other immediately available alternatives may benefit from interim use of sulfadoxine-pyrimethamine while awaiting implementation of combination antimalarial treatments.
在1993年马拉维将一线治疗药物从氯喹改为周效磺胺-乙胺嘧啶后，评估1998年至2002年期间周效磺胺-乙胺嘧啶治疗恶性疟的疗效。
前瞻性开放标签药物疗效研究。
马拉维布兰太尔附近一个大型城郊镇的健康中心。
到健康中心就诊的非复杂性恶性疟患者。
随访14天和28天时对标准周效磺胺-乙胺嘧啶治疗的疗效及寄生虫学耐药性。
治疗效果保持稳定，在整个五年研究期间临床有效率达80%或更高。对28天随访的分析显示，在研究期间随着时间推移临床和寄生虫学疗效呈适度但显著的下降趋势。
与预期相反，周效磺胺-乙胺嘧啶在马拉维作为一线抗疟药物使用10年后仍保持良好疗效。氯喹疗效极低、周效磺胺-乙胺嘧啶疗效高且无其他可用替代药物的非洲国家，在等待联合抗疟治疗实施期间，可从临时使用周效磺胺-乙胺嘧啶中获益。
