Nambei Wilfrid S, Doui-Doumgba Antoine, Bobossi Gustave, Siadoua Marcelle Desienne, Madji Nestor, Folokete Rose, Koula Max, Garraud Olivier
Département de parasitologie, Faculté des sciences de la santé, BP 1304, Bangui, RCA.
Sante. 2008 Jan-Mar;18(1):49-53. doi: 10.1684/san.2008.0102.
Transmission of malaria in the Central African Republic is holoendemic. The disease accounts for 40% of medical consultations and is the leading cause of morbidity and mortality. Central African Republic is classified by WHO in zone C for resistance to traditional anti-malaria drugs such as chloroquine, sulfadoxine-pyrimethamine, and amodiaquine. In this setting, our study sought to evaluate the therapeutic effectiveness and the feasibility (acceptability) of artemether in the treatment of uncomplicated malaria in young children in Bangui.
This non-comparative, cross-sectional, open study included children aged from 6 months to 5 years of age treated for uncomplicated malaria at the Urban Health Center (CSU) of Bédé-Combatant from May through November 2005. All children had a specific Plasmodium falciparum infection and both parasitemia ranging from 2,000 to 100,000 parasites/microL in uncomplicated malaria and an axillary temperature of 37.5 degrees C or higher but lower than 39.5 degrees C. Epi info software, version 6.03, was used for the data analysis.
The study included 53 children, only 49 of whom could be analysed. An adequate clinical and parasitological response (ACPR) was obtained for 47 (96%), early therapeutic failure was detected for 1 patient (on D2), and late parasitological failure on D14 for another. On the whole, only 4% could be qualified as early or late treatment failure. Tolerance was excellent.
Artemether was well tolerated. This agent is an effective and safe alternative for the treatment of uncomplicated P. falciparum malaria in children in the Central African Republic.
中非共和国的疟疾传播呈高度地方性流行。该疾病占医疗咨询的40%，是发病和死亡的主要原因。世卫组织将中非共和国列为对氯喹、磺胺多辛-乙胺嘧啶和阿莫地喹等传统抗疟药物耐药的C区。在此背景下，我们的研究旨在评估蒿甲醚治疗班吉幼儿单纯性疟疾的疗效和可行性（可接受性）。
这项非对照、横断面、开放性研究纳入了2005年5月至11月在贝德战斗员城市卫生中心（CSU）接受单纯性疟疾治疗的6个月至5岁儿童。所有儿童均感染特定的恶性疟原虫，单纯性疟疾患者每微升血液中的疟原虫血症范围为2000至100000个寄生虫，腋窝温度为37.5摄氏度或更高但低于39.5摄氏度。使用Epi info软件6.03版进行数据分析。
该研究纳入了53名儿童，其中只有49名可进行分析。47名（96%）获得了充分的临床和寄生虫学反应（ACPR），1名患者（在第2天）出现早期治疗失败，另1名在第14天出现晚期寄生虫学失败。总体而言，只有4%可被判定为早期或晚期治疗失败。耐受性良好。
蒿甲醚耐受性良好。该药物是治疗中非共和国儿童单纯性恶性疟的一种有效且安全的替代药物。
