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Trop Med Int Health. 2007 Jul;12(7):886-94.

Dramatically decreased therapeutic efficacy of chloroquine and sulfadoxine-pyrimethamine, but not mefloquine, in southern Benin.

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1
Research Unit 010 (UR010), Mother and Child Health in the Tropics, Development Research Institute (IRD), Cotonou, Benin. agnes.aubouy@ird.fr

Abstract

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.

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