Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan

Ingrid V.F. van den Broek; T. Gatkoi; B. Lowoko; A. Nzila; E. Ochong; K. Keus

doi:10.1016/S0035-9203(03)90128-3

Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan

Ingrid V.F. van den Broek
, T. Gatkoi
, B. Lowoko
, A. Nzila
, E. Ochong
, K. Keus

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

The current first-line and second-line drugs for Plasmodium falciparum malaria in South Sudan, chloroquine and sulfadoxine-pyrimethamine (SP), were evaluated and compared with amodiaquine, in an MSF-Holland-run clinic in eastern Upper Nile, South Sudan from June to December 2001. Patients with uncomplicated malaria and fever were stratified by age group and randomly allocated to one of 3 treatment regimes. A total of 342 patients was admitted and followed for 14 d after treatment. The dropout rate was 10.2%. Of those who completed the study, 104 were treated with chloroquine (25 mg/kg, 3 d), 102 with SP (25 mg/kg sulfadoxine and 1.25 mg/kg pyrimethamine, single dose) and 101 with amodiaquine (25 mg/kg, 3 d). Adequate clinical response was observed in 88.5% of patients treated with chloroquine, 100% of patients treated with SP and 94.1% of patients treated with amodiaquine. In children aged < 5 years, the success rate was lower: 83.3% for chloroquine and 93.0% for amodiaquine. In adults no treatment failures were found, but children aged 5-15 years showed intermediate levels. In addition, we determined the initial genotypes of dhfr and dhps of 44 isolates from the SP-treated group and > 80% were found to be wild type for dhfr and 100% for dhps. Two percent of isolates had a single mutation and 16% had double mutations of dhfr. These data are in full agreement with the clinical effectiveness of SP. A change in malaria treatment protocols for South Sudan is recommended.

Original language	English
Pages (from-to)	229-235
Number of pages	7
Journal	Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume	97
Issue number	2
DOIs	https://doi.org/10.1016/S0035-9203(03)90128-3
State	Published - 2003
Externally published	Yes

Bibliographical note

Funding Information:
workers The authors in Lankien thank for the their malaria unremitting laboratory assistance staff and in clinic the project, as well as the local authorities for their cooperation and the Nuer community for participation in the study. All support from MSF-H South Sudan staff is gratefully acknowledged, as well as support from MSF-H Amsterdam headquarters, especially K. Ritmeijer and R. Davidson. Comments on the proposals and earlier versions of the manuscript of Prof. R. W. Snow (Wellcome Trust, Nairobi) and Drs J. Rigal and P. Ringwald (WHO, Geneva) were highly appreciated. This study received ftmding from MSF-Germany and her donors. Support from the National Institute of Health of the USA (NIH Fogarty International grant TW 01186) and advice for the PCR/genotyping studies from Dr C. Sibley are gratefully acknowledged.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Amodiaquine
Chemotherapy
Chloroquine
Genotype
Malaria
Plasmodium falciparum
Resistance
South Sudan
Sulfadoxine-pyrimethamine

ASJC Scopus subject areas

Parasitology
Public Health, Environmental and Occupational Health
Infectious Diseases

Access to Document

10.1016/S0035-9203(03)90128-3

Cite this

van den Broek, I. V. F., Gatkoi, T., Lowoko, B., Nzila, A., Ochong, E., & Keus, K. (2003). Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 97(2), 229-235. https://doi.org/10.1016/S0035-9203(03)90128-3

@article{f5387386991648a3ae78d5aafa25bdbb,

title = "Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan",

abstract = "The current first-line and second-line drugs for Plasmodium falciparum malaria in South Sudan, chloroquine and sulfadoxine-pyrimethamine (SP), were evaluated and compared with amodiaquine, in an MSF-Holland-run clinic in eastern Upper Nile, South Sudan from June to December 2001. Patients with uncomplicated malaria and fever were stratified by age group and randomly allocated to one of 3 treatment regimes. A total of 342 patients was admitted and followed for 14 d after treatment. The dropout rate was 10.2\%. Of those who completed the study, 104 were treated with chloroquine (25 mg/kg, 3 d), 102 with SP (25 mg/kg sulfadoxine and 1.25 mg/kg pyrimethamine, single dose) and 101 with amodiaquine (25 mg/kg, 3 d). Adequate clinical response was observed in 88.5\% of patients treated with chloroquine, 100\% of patients treated with SP and 94.1\% of patients treated with amodiaquine. In children aged < 5 years, the success rate was lower: 83.3\% for chloroquine and 93.0\% for amodiaquine. In adults no treatment failures were found, but children aged 5-15 years showed intermediate levels. In addition, we determined the initial genotypes of dhfr and dhps of 44 isolates from the SP-treated group and > 80\% were found to be wild type for dhfr and 100\% for dhps. Two percent of isolates had a single mutation and 16\% had double mutations of dhfr. These data are in full agreement with the clinical effectiveness of SP. A change in malaria treatment protocols for South Sudan is recommended.",

keywords = "Amodiaquine, Chemotherapy, Chloroquine, Genotype, Malaria, Plasmodium falciparum, Resistance, South Sudan, Sulfadoxine-pyrimethamine",

author = "\{van den Broek\}, \{Ingrid V.F.\} and T. Gatkoi and B. Lowoko and A. Nzila and E. Ochong and K. Keus",

note = "Funding Information: workers The authors in Lankien thank for the their malaria unremitting laboratory assistance staff and in clinic the project, as well as the local authorities for their cooperation and the Nuer community for participation in the study. All support from MSF-H South Sudan staff is gratefully acknowledged, as well as support from MSF-H Amsterdam headquarters, especially K. Ritmeijer and R. Davidson. Comments on the proposals and earlier versions of the manuscript of Prof. R. W. Snow (Wellcome Trust, Nairobi) and Drs J. Rigal and P. Ringwald (WHO, Geneva) were highly appreciated. This study received ftmding from MSF-Germany and her donors. Support from the National Institute of Health of the USA (NIH Fogarty International grant TW 01186) and advice for the PCR/genotyping studies from Dr C. Sibley are gratefully acknowledged.",

year = "2003",

doi = "10.1016/S0035-9203(03)90128-3",

language = "English",

volume = "97",

pages = "229--235",

journal = "Transactions of the Royal Society of Tropical Medicine and Hygiene",

issn = "0035-9203",

publisher = "Oxford University Press",

number = "2",

}

van den Broek, IVF, Gatkoi, T, Lowoko, B, Nzila, A, Ochong, E & Keus, K 2003, 'Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan', Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 97, no. 2, pp. 229-235. https://doi.org/10.1016/S0035-9203(03)90128-3

Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan. / van den Broek, Ingrid V.F.; Gatkoi, T.; Lowoko, B. et al.
In: Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 97, No. 2, 2003, p. 229-235.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan

AU - van den Broek, Ingrid V.F.

AU - Gatkoi, T.

AU - Lowoko, B.

AU - Nzila, A.

AU - Ochong, E.

AU - Keus, K.

N1 - Funding Information: workers The authors in Lankien thank for the their malaria unremitting laboratory assistance staff and in clinic the project, as well as the local authorities for their cooperation and the Nuer community for participation in the study. All support from MSF-H South Sudan staff is gratefully acknowledged, as well as support from MSF-H Amsterdam headquarters, especially K. Ritmeijer and R. Davidson. Comments on the proposals and earlier versions of the manuscript of Prof. R. W. Snow (Wellcome Trust, Nairobi) and Drs J. Rigal and P. Ringwald (WHO, Geneva) were highly appreciated. This study received ftmding from MSF-Germany and her donors. Support from the National Institute of Health of the USA (NIH Fogarty International grant TW 01186) and advice for the PCR/genotyping studies from Dr C. Sibley are gratefully acknowledged.

PY - 2003

Y1 - 2003

N2 - The current first-line and second-line drugs for Plasmodium falciparum malaria in South Sudan, chloroquine and sulfadoxine-pyrimethamine (SP), were evaluated and compared with amodiaquine, in an MSF-Holland-run clinic in eastern Upper Nile, South Sudan from June to December 2001. Patients with uncomplicated malaria and fever were stratified by age group and randomly allocated to one of 3 treatment regimes. A total of 342 patients was admitted and followed for 14 d after treatment. The dropout rate was 10.2%. Of those who completed the study, 104 were treated with chloroquine (25 mg/kg, 3 d), 102 with SP (25 mg/kg sulfadoxine and 1.25 mg/kg pyrimethamine, single dose) and 101 with amodiaquine (25 mg/kg, 3 d). Adequate clinical response was observed in 88.5% of patients treated with chloroquine, 100% of patients treated with SP and 94.1% of patients treated with amodiaquine. In children aged < 5 years, the success rate was lower: 83.3% for chloroquine and 93.0% for amodiaquine. In adults no treatment failures were found, but children aged 5-15 years showed intermediate levels. In addition, we determined the initial genotypes of dhfr and dhps of 44 isolates from the SP-treated group and > 80% were found to be wild type for dhfr and 100% for dhps. Two percent of isolates had a single mutation and 16% had double mutations of dhfr. These data are in full agreement with the clinical effectiveness of SP. A change in malaria treatment protocols for South Sudan is recommended.

AB - The current first-line and second-line drugs for Plasmodium falciparum malaria in South Sudan, chloroquine and sulfadoxine-pyrimethamine (SP), were evaluated and compared with amodiaquine, in an MSF-Holland-run clinic in eastern Upper Nile, South Sudan from June to December 2001. Patients with uncomplicated malaria and fever were stratified by age group and randomly allocated to one of 3 treatment regimes. A total of 342 patients was admitted and followed for 14 d after treatment. The dropout rate was 10.2%. Of those who completed the study, 104 were treated with chloroquine (25 mg/kg, 3 d), 102 with SP (25 mg/kg sulfadoxine and 1.25 mg/kg pyrimethamine, single dose) and 101 with amodiaquine (25 mg/kg, 3 d). Adequate clinical response was observed in 88.5% of patients treated with chloroquine, 100% of patients treated with SP and 94.1% of patients treated with amodiaquine. In children aged < 5 years, the success rate was lower: 83.3% for chloroquine and 93.0% for amodiaquine. In adults no treatment failures were found, but children aged 5-15 years showed intermediate levels. In addition, we determined the initial genotypes of dhfr and dhps of 44 isolates from the SP-treated group and > 80% were found to be wild type for dhfr and 100% for dhps. Two percent of isolates had a single mutation and 16% had double mutations of dhfr. These data are in full agreement with the clinical effectiveness of SP. A change in malaria treatment protocols for South Sudan is recommended.

KW - Amodiaquine

KW - Chemotherapy

KW - Chloroquine

KW - Genotype

KW - Malaria

KW - Plasmodium falciparum

KW - Resistance

KW - South Sudan

KW - Sulfadoxine-pyrimethamine

UR - https://www.scopus.com/pages/publications/0142061643

U2 - 10.1016/S0035-9203(03)90128-3

DO - 10.1016/S0035-9203(03)90128-3

M3 - Article

C2 - 14584383

AN - SCOPUS:0142061643

SN - 0035-9203

VL - 97

SP - 229

EP - 235

JO - Transactions of the Royal Society of Tropical Medicine and Hygiene

JF - Transactions of the Royal Society of Tropical Medicine and Hygiene

IS - 2

ER -

Chloroquine, sulfadoxine-pyrimethamine and amodiaquine efficacy for the treatment of uncomplicated Plasmodium falciparum malaria in Upper Nile, South Sudan

Abstract

Bibliographical note

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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