Efficacy and Safety of Artesunate-Amodiaquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Plasmodium falciparum Malaria in Sentinel Sites across Côte d’Ivoire

Abstract

Two years after the introduction of free Artesunate-Amodiaquine (ASAQ) and Artemether-Lumefantrine (AL) for the treatment of uncomplicated malaria in public health facilities in Côte d'Ivoire, we carried out this study to compare their efficacy and tolerability in three surveillance sites. It was a multicentre open randomised clinical trial of 3-day ASAQ treatment against AL for the treatment of 2 parallel groups of patients aged 2 years and above. The endpoints were (1) Adequate Clinical and Parasitological Response (ACPR) at day 28 and (2) the clinical and biological tolerability. Of the 300 patients who were enrolled 289, with 143 (49.5%) and 146 (50.5%) in the ASAQ and AL groups, respectively, correctly followed the WHO 2003 protocol we used. The PCR-corrected ACPR was 99.3% for each group. More than 94% of patients no longer showed signs of fever, 48 hours after treatment. Approximately 78% of the people in the ASAQ group had a parasite clearance time of 48 hours or less compared to 81% in the AL group (p = 0.496). Both drugs were found to be well tolerated by the patients. This study demonstrates the effectiveness and tolerability of ASAQ and AL supporting their continuous use for the treatment of uncomplicated P. falciparum malaria infection in Côte d'Ivoire.

Consequences of restricting antimalarial drugs to rapid diagnostic test‐positive febrile children in south‐west Nigeria

“…This can be explained by very high malaria transmission in the rural study site and the possible development of tolerance to ASAQ over time. The day 28 ACPR observed in this study is lower than that reported by several studies in sub‐Saharan Africa . However, the ACPR observed in this study needs to be interpreted with caution because this is not a clinical efficacy study of ASAQ, and it did not have strict inclusion/exclusion criteria, such as specific parasite density cut off or absence of any co‐morbidity.…”

Malaria parasite clearance from patients following artemisinin-based combination therapy in Côte d’Ivoire

“…Results from these studies demonstrated an estimated PCT of 48 hours for both AS + AQ and AL. 18 , 19 , 26 However, these estimations of PCT have some limitations. Determination of PCT based on daily sampling lacks precision since the exact time of parasite count is not recorded.…”

Efficacy of Artesunate/Amodiaquine in the Treatment of Uncomplicated Malaria among Children in Ghana

“…10,20,21 Studies in other parts of Africa have also shown cure rates greater than 90%. [22][23][24][25] There was no treatment failure observed during the first 2 weeks of followup. Late treatment failure occurred on days 21 and 28 in the two ecological zones.…”