Koram Kwadwo A, Abuaku Benjamin, Duah Nancy, Quashie Neils
Epidemiology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
Acta Trop. 2005 Sep;95(3):194-203. doi: 10.1016/j.actatropica.2005.06.018.
The emergence and spread of Plasmodium falciparum resistance to commonly used antimalarials such as chloroquine and sulphadoxine/pyrimethamine poses major challenges to malaria control in sub-Saharan Africa. We undertook a study on the efficacy of some antimalarial drugs in 2003 with the view of supporting the National Malaria Control Programme in the review of the antimalarial drug treatment policy in Ghana. Children aged 6-59 months with signs/symptoms of uncomplicated malaria including axillary temperature > or =37.5 degrees C; mono infection with P. falciparum; and parent's willingness to give consent, were randomized into four treatment groups and followed up for a maximum of 28 days. The treatment groups were chloroquine (CHQ), sulphadoxine/pyrimethamine (SP), amodiaquine+artesunate (ADQ+ART) combination, and artemether+lumefantrine (Coartem) combination. Clinical evaluation of 168 children studied showed that cumulative pcr-corrected cure rates on day 28 were 100% for ADQ+ART; 97.5% for coartem, 60% for SP and 25% for CHQ. The artemisinin-based combinations effected rapid fever and parasite clearance. Prevalence of gametocytaemia was highest in the SP group whilst the CHQ group did not show any significant changes in haemoglobin levels during the follow-up period. The findings are in agreement with current recommendations for using artemisinin-based combinations for treating uncomplicated malaria in areas of high CHQ failure such as Ghana.
恶性疟原虫对氯喹和磺胺多辛/乙胺嘧啶等常用抗疟药产生耐药性并扩散，这给撒哈拉以南非洲地区的疟疾防治带来了重大挑战。2003年，我们开展了一项关于某些抗疟药疗效的研究，旨在支持加纳国家疟疾防治计划对该国抗疟药治疗政策进行审查。年龄在6至59个月、出现单纯性疟疾体征/症状（包括腋窝温度≥37.5摄氏度）、单感染恶性疟原虫且父母愿意给予同意的儿童，被随机分为四个治疗组，并进行了最长28天的随访。治疗组分别为氯喹（CHQ）、磺胺多辛/乙胺嘧啶（SP）、阿莫地喹+青蒿琥酯（ADQ+ART）联合用药组以及蒿甲醚+本芴醇（科泰复）联合用药组。对168名研究儿童的临床评估显示，第28天经PCR校正后的累积治愈率分别为：ADQ+ART组100%；科泰复组97.5%；SP组60%；CHQ组25%。以青蒿素为基础的联合用药能迅速退热并清除寄生虫。配子体血症患病率在SP组最高，而CHQ组在随访期间血红蛋白水平未出现任何显著变化。这些研究结果与目前在加纳等高氯喹治疗失败地区使用以青蒿素为基础的联合用药治疗单纯性疟疾的建议一致。
