TY - JOUR
T1 - Therapeutic efficacy of quinine plus sulfadoxine-pyremethamine for the treatment of uncomplicated falciparum malaria in Bangladesh
AU - Thriemer, Kamala
AU - Haque, Rashidul
AU - Wagatsuma, Yukiko
AU - Salam, Mohammed Abdus
AU - Akther, Selim
AU - Attlmayr, Bernhard
AU - Fukuda, Mark
AU - Schaecher, Kurt
AU - Miller, R. Scott
AU - Noedl, Harald
PY - 2006/1/1
Y1 - 2006/1/1
N2 - In terms of drug resistance Bangladesh acts as an important gateway to the Indian Subcontinent. However, little is known about the current status of drug resistance in this country. The aim of this study was therefore to determine the therapeutic efficacy as well as in vitro drug sensitivity of quinine for 3 days plus a single dose of sulfadoxine/pyrimethamine (Q3F), an affordable alternative to the previously used chloroquine, for the treatment of uncomplicated falciparum malaria. Sixty-three patients were enrolled in the study; the overall cure rate in a 42-day follow-up after PCR adjustment was 87.3% (95% CI: 77.6-94.1). One patient was classified as early treatment failure (1.7%, 95% CI: 0.0-8.9%); 6 patients (10%; 95% CI: 3.8-20.5%) had late treatment failures within a median time of 27 days. HRP2 in vitro drug sensitivity tests were performed on all samples. Significantly higher (P = 0.008) in vitro IC50s for pyrimethamine in treatment failures reflect the somewhat compromised drug sensitivity to this drug. These data suggest that the combination of 3 days of quinine with a single dose of sulfadoxine/ pyrimethamine is an interesting and affordable alternative as long as or whenever ACT is not available.
AB - In terms of drug resistance Bangladesh acts as an important gateway to the Indian Subcontinent. However, little is known about the current status of drug resistance in this country. The aim of this study was therefore to determine the therapeutic efficacy as well as in vitro drug sensitivity of quinine for 3 days plus a single dose of sulfadoxine/pyrimethamine (Q3F), an affordable alternative to the previously used chloroquine, for the treatment of uncomplicated falciparum malaria. Sixty-three patients were enrolled in the study; the overall cure rate in a 42-day follow-up after PCR adjustment was 87.3% (95% CI: 77.6-94.1). One patient was classified as early treatment failure (1.7%, 95% CI: 0.0-8.9%); 6 patients (10%; 95% CI: 3.8-20.5%) had late treatment failures within a median time of 27 days. HRP2 in vitro drug sensitivity tests were performed on all samples. Significantly higher (P = 0.008) in vitro IC50s for pyrimethamine in treatment failures reflect the somewhat compromised drug sensitivity to this drug. These data suggest that the combination of 3 days of quinine with a single dose of sulfadoxine/ pyrimethamine is an interesting and affordable alternative as long as or whenever ACT is not available.
UR - http://www.scopus.com/inward/record.url?scp=33750615609&partnerID=8YFLogxK
U2 - 10.4269/ajtmh.2006.75.645
DO - 10.4269/ajtmh.2006.75.645
M3 - Article
C2 - 17038687
AN - SCOPUS:33750615609
VL - 75
SP - 645
EP - 649
JO - The American Journal of Tropical Medicine and Hygiene
JF - The American Journal of Tropical Medicine and Hygiene
SN - 0002-9637
IS - 4
ER -