| Autor: |
Mayxay, Mayfong, Khanthavong, Maniphone, Lindegårdh, Niklas, Keola, Siamphay, Barends, Marion, Pongvongsa, Tiengkham, Yapom, Ratsuda, Annerberg, Anna, Phompida, Samlane, Phetsouvanh, Rattanaxay, White, Nicholas J., Newton, Paul N. |
| Předmět: |
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| Zdroj: |
Clinical Infectious Diseases; 10/15/2004, Vol. 39 Issue 8, p1139-1147, 9p |
| Abstrakt: |
Background. Recent clinical trials in the Lao People's Democratic Republic have demonstrated that chloroquine and sulfadoxine-pyrimethamine, which are national malaria treatment policy, are no longer effective in the treatment of uncomplicated Plasmodium falciparum malaria. Methods. A randomized comparison of 3 oral antimalarial combinations-chloroquine plus sulfadoxine- pyrimethamine versus artesunate plus mefloquine versus artemether-lumefantrine-with 42-day follow-up period, was conducted among 330 patients with acute uncomplicated falciparum malaria in southern Laos. Results. The 42-day cure rates, as determined by intention-to-treat analysis and adjusted for reinfection, were 100%, 97%, and 93% for the groups receiving artesunate plus mefloquine, artemether-lumefantrine, and chloroquine plus sulfadoxine-pyrimethamine, respectively. Of 8 patients receiving chloroquine plus sulfadoxine-pyrimethamine who experienced treatment failure, 6 had early treatment failure. The mean parasite clearance time was significantly longer in patients treated with chloroquine plus sulfadoxine-pyrimethamine (2.9 days; 95% confidence interval [I], 2.8-3.0 days) than in those treated with artesunate plus mefloquine (2.07 days; 95% CI, 2.0-2.1 days; P< .001) and artemether-lumefantrine (2.08 days; 95% CI, 2.0-2.1 days; P< .001). Cure rates with artemether-lumefantrine were high despite low mean daily dietary fat intake (13.8 g; 95% CI, 12.5-15.1 g) and day 7 plasma lumefantrine concentrations (0.47 μg/mL; 95% CI, 0.38-0.56 μg/mL). Conclusion. Oral artesunate plus mefloquine and artemether-lumefantrine are highly effective for the treatment of uncomplicated falciparum malaria in Laos. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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