Journal de pathologie clinique et expérimentale

Abstrait

Efficacy of Artesunate Plus Amodiaquine for Treatment of Uncomplicated Clinical Falciparum Malaria in Severely Malnourished Children Aged 6?59 Months, Democratic Republic of Congo

P. Mitangala Ndeba, U. D’Alessandro, P. Hennart, P. Donnen, D. Porignon, G. Bisimwa Balaluka, A. Bisimwa Nkemba, N Cobohwa Mbiribindi and M. Dramaix Wilmet

Abstract
Background: Recent published studies on efficacy and safety of antimalarial treatment in children with Severe
Acute Malnutrition (SAM) suffering from uncomplicated malaria are not available.
Methods: Between March 2007 and December 2010 the efficacy of AS+AQ in treating uncomplicated malaria
children under five with SAM was carried out in Lwiro (Eastern Republic Democratic of Congo) according to the WHO
standard protocol. Among the 445 children included, 69 had SAM. AS+AQ was given according to national protocol.
Analysis was done using per protocol method. Odds ratio (OR) and their 95% confidence interval (95% CI) were
computed.
Results: The treatment failure rate was 24.4% of 414 infections included in the analysis. After adjustment for
malaria parasitemia, ACPR in children without SAM were 73.0% when it was 91.4% among those with SAM (OR
3.15 95%CI 1.19 – 8.30). Malaria parasitemia median at admission was statistically low among children who had
subsequently Adequate Clinical and Parasitological Response (ACPR).
Conclusion: AS+AQ has a good efficacy among children with both uncomplicated falciparum malaria and
malnutrition including severe acute form. AS+AQ dosing national strategy unmodified can be used, to treat under five
children with malnutrition including severe acute form suffering from uncomplicated malaria.