Assessment of the Public Health Benefit of artemisinin based
combination therapies for uncomplicated malaria treatment in Mali
1. To test the hypothesis that repeated administration of
artesunate+amodiaquine (AS+AQ (Arsucam)), artesunate plus
sulphadoxine-pyrimethamine (AS/SP) and artemether-lumefantrine
(AR-L (Coartem)) for treatment of consecutive episodes of
uncomplicated malaria reduces the incidence of uncomplicated
2. To measure the impact of repeated administration of the drugs on
malarial immunity and malaria transmission
Study results showed that in this setting of perennial transmission with
seasonal peaks, the incidence density of malaria in the AS + SP and
Arsucam® arms were reduced as compared to the ARL arm. Using crude
efficacy, ARL was also significantly less efficacious during the peak
season of malaria while all arms had similar and above 98% efficacy after
adjusting for re-infections by PCR. All ACTs maintained acceptable
clinical and laboratory safety profiles despite their repetitive usage.
Combined therapy of Arsucam or Arsumax reduced malaria incidence
more than Coartem.
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