Ménard Didier, Andrianina Nohary Nina Harimanana, Ramiandrasoa Zakaherizo, Randriamanantena Arthur, Rasoarilalao Noéline, Jahevitra Martial, Ratsimbasoa Arsène, Tuseo Luciano, Raveloson Andrianirina
Malaria Unit Research, Institut Pasteur de Madagascar, BP 1274, Antananarivo, Madagascar.
Malar J. 2007 May 22;6:65. doi: 10.1186/1475-2875-6-65.
Data concerning antimalarial combination treatment for uncomplicated malaria in Madagascar are largely lacking. Randomized clinical trial was designed to assess therapeutic efficacies of chloroquine (CQ), amodiaquine (AQ), sulphadoxine-pyrimethamine (SP), amodiaquine plus sulphadoxine-pyrimethamine combination (AQ+SP) and artesunate plus amodiaquine combination (AQ+AS).
287 children between 6 months and 15 years of age, with uncomplicated falciparum malaria, were enrolled in the study. Primary endpoints were the day-14 and day-28 risks of parasitological failure, either unadjusted or adjusted by genotyping.
All treatment regimens, except for CQ treatment, gave clinical cure rates above 97% by day-14 and 92% by day-28 (PCR-corrected). AQ+SP was as effective as AQ+AS. The risk of new infection within the month after therapy was generally higher for AQ+AS than AQ+SP.
These findings show that the inexpensive and widely available combination AQ+SP may be valuable in for the treatment of uncomplicated malaria in Madagascar and could have an important role in this country, where much of the drugs administered go to patients who do not have malaria.
马达加斯加关于单纯性疟疾联合抗疟治疗的数据极为匮乏。设计了一项随机临床试验，以评估氯喹（CQ）、阿莫地喹（AQ）、磺胺多辛-乙胺嘧啶（SP）、阿莫地喹加磺胺多辛-乙胺嘧啶联合用药（AQ+SP）以及青蒿琥酯加阿莫地喹联合用药（AQ+AS）的治疗效果。
287名6个月至15岁患有单纯性恶性疟的儿童参与了该研究。主要终点是第14天和第28天未经调整或经基因分型调整的寄生虫学失败风险。
除CQ治疗外，所有治疗方案在第14天的临床治愈率均高于97%，在第28天（经PCR校正）高于92%。AQ+SP与AQ+AS效果相当。治疗后一个月内AQ+AS的新感染风险总体上高于AQ+SP。
这些研究结果表明，价格低廉且广泛可得的联合用药AQ+SP可能对马达加斯加单纯性疟疾的治疗具有重要价值，在该国大部分药物用于非疟疾患者的情况下，它可能发挥重要作用。
