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Journal of Tropical Medicine
Volume 2009 (2009), Article ID 781865, 7 pages
Clinical Study

Efficacy of Artesunate + Sulphadoxine-Pyrimethamine (AS + SP) and Amodiaquine + Sulphadoxine-Pyrimethamine (AQ + SP) for Uncomplicated falciparum Malaria in Equatorial Guinea (Central Africa)

1Centre for the Control of Diseases, Reference Laboratory of Malaria, National Centre of Tropical Medicine—ISCIII, Malabo, Equatorial Guinea
2National Centre of Tropical Medicine, Institute of Health Carlos III, 28029 Madrid, Spain
3Reference Laboratory of Malaria, MINSABS and ISCIII, Malabo, Equatorial Guinea
4Reference Laboratory of Malaria, MINSABS and ISCIII, Bata, Equatorial Guinea
5Paediatric Department, Regional Hospital of Malabo, Malabo, Equatorial Guinea

Received 6 October 2008; Revised 11 February 2009; Accepted 26 March 2009

Academic Editor: Sukla Biswas

Copyright © 2009 Pilar Charle et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. The objectives of the study were (i) to evaluate the efficacy of combination drugs, such as artesunate + sulphadoxine-pyrimethamine (AS + SP) and amodiaquine + sulphadoxine-pyripethamine (AQ + SP) in treatment of uncomplicated falciparum malaria (ii) to differentiate recrudescence from reinfection by analysing msp-1 and msp-2 genes of Plasmodium falciparum in treatment failure cases. Methods. We carried out an in vivo study in the year 2005 in 206 children between 6 to 59 months age groups. Of the 206, 120 received AQ + SP, and 86 received AS + SP. A clinical and parasitological followup during 14 days was undertaken. Finger-prick blood sample from each patient was taken on Whatman filter paper (no. 3) on days 0, 7, 14 and also the day when the parasite and symptoms reappeared for PCR analysis. Results. Late treatment failure was observed in 3.5% (4/114) with AQ + SP, and 2.5% (2/79) with AS + SP. The success rate was 96.5% with AQ + SP and 97.5% with AS + SP. No deaths and severe reactions were recorded. Out of the 6 treatment failure cases, one was reinfection as observed by PCR analysis of msp-1 and msp-2 genes on day 14. Discussion. Both the combinations found to be efficacious and safe and could be used as a first-line treatment for uncomplicated falciparum malaria in Equatorial Guinea.