Randomised trial of chloroquine/sulphadoxine-pyrimethamine in Gambian children with malaria: Impact against multidrug-resistant P. falciparum

2006

Chloroquine and Sulphadoxine-Pyrimethamine for Malaria in Gambian Children

Sample size: 500 publication 10 minutes Evidence: moderate

Author Information

Author(s): Dunyo Samuel, Ord Rosalynn, Hallett Rachel, Jawara Musa, Walraven Gijs, Mesa Eduardo, Coleman Rosalind, Sowe Maimuna, Alexander Neal, Targett Geoffrey A. T, Pinder Margaret, Sutherland Colin J

Primary Institution: Farafenni Field Station, Medical Research Council Laboratories, Fajara, The Gambia

Hypothesis

Is the combination of chloroquine and sulphadoxine-pyrimethamine more effective than either drug alone for treating uncomplicated malaria in Gambian children?

Conclusion

The combination of chloroquine and sulphadoxine-pyrimethamine is effective for treating uncomplicated malaria in Gambian children, but the presence of multidrug-resistant parasites raises concerns about the sustainability of this efficacy.

Supporting Evidence

The prevalence of parasitological failure by day 28 was 60.3% for chloroquine, compared to 17.6% for sulphadoxine-pyrimethamine and 13.9% for the combination.
Children treated with the combination had a significantly lower rate of treatment failure compared to those treated with chloroquine alone.
The study identified high prevalence of resistance-associated genetic markers in the parasites.

Takeaway

This study tested a mix of two malaria medicines on kids in The Gambia. It found that the mix worked better than just one medicine alone, but some germs are getting stronger and might make the mix less effective in the future.

Methodology

A single-blind, randomised, controlled trial comparing the efficacy of chloroquine/sulphadoxine-pyrimethamine to chloroquine or sulphadoxine-pyrimethamine alone.