Artemether-lumefantrine versus amodiaquine plus sulfadoxine-pyrimethamine for uncomplicated falciparum malaria in Burkina Faso: a randomised non-inferiority trial

摘要: Summary Background Artemisinin-based combination regimens are widely advocated for malarial treatment, but other effective might be cheaper and more readily available. Our aim was to compare the risk of recurrent parasitaemia in patients given artemether-lumefantrine with that those amodiaquine plus sulfadoxine-pyrimethamine uncomplicated malaria. Methods We enrolled 521 aged 6 months or older falciparum malaria Bobo-Dioulasso, Burkina Faso. Patients were randomly assigned receive standard doses either (261) (260) 3 days. Primary endpoints risks treatment failure within 28 days, unadjusted adjusted by genotyping distinguish recrudescence from new infection. The study is registered at controlled-trials.gov identifier ISRCTN54261005. Findings Of patients, 478 (92%) completed 28-day study. symptomatic lowest group (1·7% vs 10·2%; difference 8·5%; 95% CI 4·3–12·6; p=0·0001); as (4·7% 15·1%; 10·4%; 5·1–15·6; p=0·0002). Nearly all recurrences due infections. Recrudescences four late failures one early sulfadoxine-pyrimethamine. Both safe well tolerated, pruritus common than artemether-lumefantrine. Each regimen selected isolates mutations have been associated decreased drug susceptibility. Interpretation Amodiaquine For regions Africa where continues effective, this less expensive available should considered an alternative blanket recommendations artemisinin-based