Chloroquine and Sulphadoxine-Pyrimethamine for Malaria in Gambian Children
Author Information
Author(s): Hallett Rachel L, Dunyo Samuel, Ord Rosalynn, Jawara Musa, Pinder Margaret, Randall Anna, Alloueche Ali, Walraven Gijs, Targett Geoffrey A. T, Alexander Neal, Sutherland Colin J
Primary Institution: London School of Hygiene and Tropical Medicine
Hypothesis
How do chloroquine and sulphadoxine-pyrimethamine affect the transmission of multidrug-resistant malaria parasites to mosquitoes?
Conclusion
Multidrug-resistant parasites had a significant transmission advantage after treatment with chloroquine and sulphadoxine-pyrimethamine, but this did not affect the overall efficacy of the treatment.
Supporting Evidence
- Children treated with chloroquine and sulphadoxine-pyrimethamine had similar rates of gametocyte carriage compared to those treated with chloroquine alone.
- Parasites with the TYRG genotype were more likely to be transmitted to mosquitoes after treatment with chloroquine/sulphadoxine-pyrimethamine.
- The study included 500 children, making it a robust sample size for assessing treatment efficacy.
- Posttreatment gametocyte emergence was observed in all treatment groups, indicating ongoing transmission potential.
- Children treated with sulphadoxine-pyrimethamine were significantly more likely to become gametocyte carriers than those treated with the combination or chloroquine alone.
Takeaway
The study found that children treated for malaria with a combination of two drugs can still pass on drug-resistant parasites to mosquitoes, but the treatment still works well for curing the illness.
Methodology
A single-blind, randomised, controlled trial with follow-up over 28 days, measuring posttreatment gametocyte prevalence and density.
Limitations
The results may not fully represent the current situation as the trial was conducted in 2001 and resistance levels may have changed since then.
Participant Demographics
Children aged 6 months to 10 years with uncomplicated P. falciparum malaria.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI, 1.95–13.9
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website