The comparative efficacies of malartin, with and without amodiaquine, in the treatment of Plasmodium falciparum malaria in the Buea district of Cameroon

Abstract

The in-vivo efficacies of the artesunate malartin, alone and in combination with amodiaquine, have been assessed against uncomplicated cases of Plasmodium falciparum malaria attending two treatment centres in Cameroon (the WHO/University of Buea malaria health post in Bolifamba and the University of Buea's health centre in Molyko). The 213 participants were treated for 3 days (malartin–amodiaquine) or 5 days (malartin alone) and then followed-up on days 3, 7 and 14. Only 86 of the patients given malartin alone and 80 of those given malartin–amodiaquine completed follow-up. Most patients given malartin alone showed an adequate clinical and parasitological response (91.9%), the rest showing late parasitological failure (7.0 %) or early treatment failure (1.2%). The corresponding values for the malartin–amodiaquine combination were slightly better, at 93.8%, 5.0 % and 1.2%, respectively. No late clinical failures were recorded in either treatment arm. In both treatment arms, the prevalence of anaemia in the treated adults (aged >15 years) and children decreased significantly during follow-up (P<0.05). Both regimens were well tolerated and neither gave rise to any serious adverse effects. The most common side-effects were dizziness and fatigue in those given malartin alone and fatigue, itching and nausea in those given malartin–amodiaquine. Three days of treatment with the malartin–amodiaquine combination appears to be slightly more effective and a slightly better choice than 5 days of treatment with malartin alone.