Faculty of Health Science
School of Public Health
0418444d
benido_impouma@yahoo.com / Study objectives
The objective of this meta-analysis was to review the comparative efficacy and
tolerance of sulfadoxine-pyrimethamine (SP) given alone or in combination with one
(SPAS1) or three (SPAS3) doses of artesunate in children with uncomplicated P.
falciparum malaria, aged 6 months to 10 years. Specifically, it assessed cure rate, fever
and parasite clearance time, gametocyte carriage and tolerability.
Methods
The methodology used was a systematic review and a meta-analysis of four randomised
controlled trials. The primary endpoint was the parasitological cure rate at day 28.
Secondary endpoint included the parasitological cure rate at day 14, time to fever and
parasite clearance, gametocyte carriage and occurrence of adverse events.
Results
Cure rate at day 28 corrected by PCR was 2.5 times higher in the combination of
SPAS3 than in SP alone (pooled OR=2.55, 95% CI 1.93 to 3.37). There was no
difference in cure rate at day 28 corrected by PCR between the combination of SPAS1
and SP alone (pooled OR=1.06 95% CI 0.98 to 1.15). Fever and parasite clearance
times were significantly faster in both SPAS1 and SPAS3 compared to SP alone
(p<0.001). By day 28 all children on the combination therapy were agametocytaemic as
opposed to those on SP alone (p<0.001). All drug regimens were well tolerated and
safe.
Conclusion
The combination of SPAS3 is more efficacious than SP alone in treatment of children
with uncomplicated P. falciparum malaria. The combination is recommended for
adoption as a replacement for SP alone in areas where malaria is endemic.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/1835 |
| Date | 17 November 2006 |
| Creators | Benido, Impouma |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 291091 bytes, 71760 bytes, 138190 bytes, 58028 bytes, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf, application/pdf |
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