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Title: Chloroquine versus sulfadoxine-pyrimethamine for treatment of Plasmodium falciparum malaria in Savannakhet Province, Lao People's Democratic Republic: An assessment of National Antimalarial Drug Recommendations
Authors: Mayxay, M; Newton, PN; Khanthavong, M; Tiengkham, P; Phetsouvanh, R; Phompida, S; Brockman, A; White, NJ
Issue Date: 2003
Citation: Clin. Infect. Dis.;15-Oct;2003;37;8
Abstract: The in vivo efficacies of the Lao People's Democratic Republic ( Laos) nationally recommended antimalarial agents - chloroquine and sulfadoxine-pyrimethamine - were assessed in a randomized, comparative trial that involved 100 patients with uncomplicated Plasmodium falciparum malaria who were followed for 42 days after starting treatment. Despite a shorter mean time to fever clearance associated with administration of chloroquine ( mean time to clearance, 35.6 h; 95% confidence interval [CI], 26.3-45.0 h), compared with that associated with sulfadoxine-pyrimethamine (61.1 h; 95% CI, 50.9-71.3 h;), treatment failures were P < .001 twice as frequent among patients receiving chloroquine therapy than among those receiving sulfadoxine-pyrimethamine therapy (36% vs. 18%; P = .02). Of 23 treatment failures, 10 (43%) were high grade. Treatment failure rates among children ( age range, 5 - 15 years) were 4.9 times higher ( 95% CI, 2 - 12) than those among adults (P < .0001). Gametocytemia after antimalarial treatment was associated with receipt of sulfadoxine-pyrimethamine therapy and with treatment failure (P = .009). The efficacy of both chloroquine and sulfadoxine-pyrimethamine in Laos is unsatisfactory.
ISSN: 1058-4838

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