A randomized trial of artesunate-amodiaquine versus artemether-lumefantrine in Ghanaian paediatric sickle cell and non-sickle cell disease patients with acute uncomplicated malaria

Sickle cell disease (SCD) is a genetic disorder common in malaria endemic areas. In endemic areas, malaria is a major cause of morbidity and mortality among SCD patients. This suggests the need for prompt initiation of efficacious anti-malarial therapy in SCD patients with acute malaria. However, th...

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Bibliographic Details
Published in:Malaria journal 2014-09, Vol.13 (1), p.369-369, Article 369
Main Authors: Adjei, George O, Goka, Bamenla Q, Enweronu-Laryea, Christabel C, Rodrigues, Onike P, Renner, Lorna, Sulley, Abdul M, Alifrangis, Michael, Khalil, Insaf, Kurtzhals, Jorgen A
Format: Article
Language:English
Subjects:
Amodiaquine - therapeutic use
Analysis
Anemia, Sickle Cell - parasitology
Anemia, Sickle Cell - physiopathology
Antimalarials - therapeutic use
Artemisinins - therapeutic use
Blood Cell Count
Care and treatment
Child
Child, Preschool
Children & youth
Colleges & universities
Comparative analysis
Complications and side effects
Drug Combinations
Drug therapy
Ethanolamines - therapeutic use
Fluorenes - therapeutic use
Genetic aspects
Ghana
Health aspects
Hemoglobins - metabolism
Hospitals
Humans
Malaria
Malaria, Falciparum - blood
Malaria, Falciparum - drug therapy
Malaria, Falciparum - parasitology
Mortality
Parasite Load
Patient outcomes
Risk factors
Sickle cell anemia
Survival Analysis
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Summary:Sickle cell disease (SCD) is a genetic disorder common in malaria endemic areas. In endemic areas, malaria is a major cause of morbidity and mortality among SCD patients. This suggests the need for prompt initiation of efficacious anti-malarial therapy in SCD patients with acute malaria. However, there is no information to date, on the efficacy or safety of artemisinin combination therapy when used for malaria treatment in SCD patients. Children with SCD and acute uncomplicated malaria (n=60) were randomized to treatment with artesunate-amodiaquine (AA), or artemether-lumefantrine (AL). A comparison group of non-SCD children (HbAA genotype; n=59) with uncomplicated malaria were also randomized to treatment with AA or AL. Recruited children were followed up and selected investigations were done on days 1, 2, 3, 7, 14, 28, 35, and 42. Selected clinical and laboratory parameters of the SCD patients were also compared with a group of malaria-negative SCD children (n=82) in steady state. The parasite densities on admission were significantly lower in the SCD group, compared with the non-SCD group (p=0.0006). The parasite reduction ratio (PRR) was lower, clearance was slower (p
ISSN:1475-2875
1475-2875
DOI:10.1186/1475-2875-13-369