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Antimicrobial Agents and Chemotherapy, May 2007, p. 1694-1699, Vol. 51, No. 5
0066-4804/07/$08.00+0     doi:10.1128/AAC.00077-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Activities of Amodiaquine, Artesunate, and Artesunate-Amodiaquine against Asexual- and Sexual-Stage Parasites in Falciparum Malaria in Children{triangledown}

Akintunde Sowunmi,* Tunde Balogun, Grace O. Gbotosho, Christian T. Happi, Ahmed A. Adedeji, and Fatai A. Fehintola

Department of Pharmacology and Therapeutics and Institute for Medical Research and Training, University of Ibadan, Ibadan, Nigeria

Received 18 January 2007/ Returned for modification 11 February 2007/ Accepted 18 February 2007

The activities of amodiaquine, artesunate, and artesunate-amodiaquine against asexual- and sexual-stage parasites were evaluated in 360 Nigerian children with uncomplicated Plasmodium falciparum malaria randomized to the standard dose regimens of the three drugs/combination. Clinical recovery from illness occurred in all children. There were no significant differences in fever clearance times. Patients treated with artesunate or artesunate-amodiaquine had significantly shorter parasite clearance times (1.4 ± 0.5 days or 1.4 ± 0.6 days versus 3.2 ± 2.3 days, P = 0.0001) and lower gametocyte carriage rates (3.3 or 1.7% versus 11.7%, P = 0.001) than those treated with amodiaquine alone. Gametocytemia was detected in 62 patients (11.7% before treatment and 5.6% after treatment). The pretreatment gametocyte sex ratio, which was female biased, increased significantly during the course of treatment with amodiaquine but not with artesunate and artesunate-amodiaquine. These results suggest that artesunate and artesunate-amodiaquine reduce gametocyte carriage and may reduce transmissibility in P. falciparum malaria by accelerating asexual clearance and influencing gametocyte sex ratio.

* Corresponding author. Mailing address: Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria. Phone: 234-2-2412101. Fax: 234-2-2411843. E-mail: akinsowunmi{at}hotmail.com

{triangledown} Published ahead of print on 26 February 2007.

Antimicrobial Agents and Chemotherapy, May 2007, p. 1694-1699, Vol. 51, No. 5
0066-4804/07/$08.00+0     doi:10.1128/AAC.00077-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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