Similar efficacy and tolerability of double-dose chloroquine and artemether-lumefantrine for treatment of Plasmodium falciparum infection in Guinea-Bissau: a randomized trial
Language: 
English
Short Title: 
Similar efficacy and tolerability of double-dose chloroquine and artemether-lumefantrine for treatment of Plasmodium falciparum infection in Guinea-Bissau
Abstract: 

BACKGROUND: In 2008, Guinea-Bissau introduced artemether-lumefantrine for treatment of uncomplicated malaria. Previously, 3 times the standard dose of chloroquine, that was probably efficacious against Plasmodium falciparum with the resistance-associated chloroquine-resistance transporter (pfcrt) 76T allele, was routinely used. The present study compared the efficacy and tolerability of a double standard dose of chloroquine with the efficacy and tolerability of artemether-lumefantrine. METHODS: In a randomized open-label clinical trial, artemether-lumefantrine or chloroquine (50 mg/kg) were given as 6 divided doses over 3 days to children aged 6 months--15 years who had uncomplicated P. falciparum monoinfection. Drug concentrations were measured on day 7. P. falciparum multidrug resistance gene N86Y and pfcrt K76T alleles were identified. RESULTS: The polymerase chain reaction-adjusted day 28 and 42 treatment efficacies were 162 (97%) of 168 and 155 (97%) of 161, respectively, for artemether-lumefantrine and 150 (95%) of 158 and 138 (94%) of 148, respectively, for chloroquine. When parasites with resistance-associated pfcrt 76T were treated, the day 28 efficacy of chloroquine was 87%. No severe drug-related adverse events were detected. Symptom resolution was similar with both treatments. CONCLUSIONS: Both treatments achieved the World Health Organization-recommended efficacy for antimalarials that will be adopted as policy. High-dose chloroquine treatment regimes should be further evaluated with the aim of assessing chloroquine as a potential partner drug to artemisinin derivatives. Clinical trials registration. NCT00426439.

Author(s): 
Ursing, Johan
Kofoed, Poul-Erik
Rodrigues, Amabelia
Blessborn, Daniel
Thoft-Nielsen, Rikke
Björkman, Anders
Rombo, Lars
Item Type: 
Journal Article
Publication Title: 
The Journal of Infectious Diseases
Journal Abbreviation: 
J. Infect. Dis.
Publication Date: 
1/1/2011
Publication Year: 
2011
Pages: 
109-116
Volume: 
203
Issue: 
1
ISSN: 
1537-6613
DOI: 
10.1093/infdis/jiq001
Library Catalog: 
PubMed
Extra: 
PMID: 21148503 PMCID: PMC3086436

Turabian/Chicago Citation

Johan Ursing, Poul-Erik Kofoed, Amabelia Rodrigues, Daniel Blessborn, Rikke Thoft-Nielsen, Anders Björkman and Lars Rombo. 1/1/2011. "Similar efficacy and tolerability of double-dose chloroquine and artemether-lumefantrine for treatment of Plasmodium falciparum infection in Guinea-Bissau: a randomized trial." The Journal of Infectious Diseases 203: 1: 109-116. 10.1093/infdis/jiq001.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1093/infdis/jiq001 | issn = 1537-6613 | volume = 203 | pages = 109-116 | last = Ursing | first = Johan | coauthors = Kofoed, Poul-Erik, Rodrigues, Amabelia, Blessborn, Daniel, Thoft-Nielsen, Rikke, Björkman, Anders, Rombo, Lars | title = Similar efficacy and tolerability of double-dose chloroquine and artemether-lumefantrine for treatment of Plasmodium falciparum infection in Guinea-Bissau: a randomized trial | journal = The Journal of Infectious Diseases | date = 1/1/2011 | pmid = | pmc = }} </ref>