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Dramática disminución de la eficacia terapéutica de cloroquina y sulfadoxina‐pirimetamina, pero no mefloquina, al sur de Benin
Author(s) -
Aubouy Agnès,
Fievet Nadine,
Bertin Gwladys,
Sagbo Jean C.,
Kossou Hortense,
KindeGazard Dorothée,
Kiniffo Richard,
Massougbodji Achille,
Deloron Philippe
Publication year - 2007
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2007.01859.x
Subject(s) - sulfadoxine/pyrimethamine , chloroquine , mefloquine , malaria , sulfadoxine , medicine , pyrimethamine , plasmodium falciparum , pharmacology , immunology
Summary Objective To evaluate the in vivo therapeutic efficacy of chloroquine (CQ), sulfadoxine‐pyrimethamine (SP) and mefloquine (MQ) in children presenting with uncomplicated malaria in Benin. Methods Drug efficacy was tested according to the WHO in vivo 28‐day protocol. For failures that occurred after 7 days of follow‐up, paired pre‐ and post‐treatment blood samples were genotyped at msp1 and msp2 loci to distinguish new infections and recrudescent strains. Children enrolled were randomly assigned to a therapeutic group (CQ, n = 14; SP, n = 42; MQ, n = 44). The number of CQ treatment was intentionally restricted after 1 month, as its use was considered to constitute a danger for children. Results Chloroquine and SP showed very high failure rates (85.7% and 50%, respectively), whereas MQ treatment was successful in 97.5%. The molecular tool allowed to re‐evaluate two new infections previously considered as failures. Conclusions Chloroquine should no longer be used to treat children presenting with Plasmodium falciparum malaria in Benin.