Associate Professor
Charles Obonyo
Project Title
Clindamycin plus quinine for treating uncomplicated falciparum malaria: an open-label randomized trial
Project Objectives
To measure the clinical and parasitological efficacy of Clindamycin plus quinine and Artemether-Lumefantrine (current recommended regimen) among patients between 6-59 months of age suffering from uncomplicated P. falciparum malaria, by determining the proportion of patients with Early Treatment Failures (ETF), Late Clinical Failures (LCF), Late Parasitological Failures (LPF), or with Adequate Clinical and Parasitological Response (ACPR) during a 28 day follow-up period.
Results & Outcomes
The unadjusted cure rate was 32.6% in the clindamycin plus quinine arm
and 78.9% in the artemether-lumefantrine arm. The cure rate after
genotyping was 44.4% in the clindamycin plus quinine arm and 97.1% in
the artemether-lumefantrine arm . Overall, 95 (53.3%) of children in the
clindamycin plus quinine group developed early treatment failure
compared to 1 (0.6%) in the artemether-lumefantrine group. By 72 hours
after starting treatment, 50% of the children in the clindamycin plus
quinine arm had not cleared their parasitemia compared to only 0.5% in
the artemether-lumefantrine group. The prevalence of gametocyte
carriage was significantly lower among children treated using artemetherlumefantrine
compared to those treated using clindamycin plus quinine.
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The mean haemoglobin increased by about 1 g/dl in both groups by day
28. The prevalence of anaemia reduced by 22% (from 69.8%) in the
clindamycin plus quinine arm and by 16% (from 75.5%) in the artemetherlumefantrine
arm. The incidence of adverse events was comparable
between the two groups. However, there were three serious adverse
events (one severe anaemia and two cases of severe malaria) in the
clindamycin plus quinine group.
The efficacy of clindamycin plus quinine in our study was significantly
lower than artemether-lumefantrine, suggesting that the continued
recommendation of quinine-based combinations as second-line
antimalarial drugs should be questioned.
Host Organisation
| Department | Institution | Country |
|---|---|---|
| Kenya Medical Research Institute (KEMRI) | Kenya |
EDCTP Project
TA.2011.40200.059
EDCTP Program
EDCTP1
EDCTP Project Call
Senior Fellowship (SF)
Study Design
Phase IV open-label randomised trial