Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa

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dc.contributor.authorMabuza, Aaron
dc.contributor.authorGovere, John
dc.contributor.authorLa Grange, Kobus
dc.contributor.authorMngomezulu, Nicros
dc.contributor.authorAllen, Elizabeth
dc.contributor.authorZitha, Alpheus
dc.contributor.authorMbokazi, Frans
dc.contributor.authorDurrheim, David
dc.contributor.authorBarnes, Karen
dc.date.accessioned2021-10-08T07:17:56Z
dc.date.available2021-10-08T07:17:56Z
dc.date.issued2005
dc.description.abstractObjectives. To assess the therapeutic efficacy of sulfadoxine-pyrimethamine (SP) after 5 years of use as first-line treatment of uncomplicated Plasmodium falciparum malaria, and thus guide the selection of artemisinin-based combination therapy in Mpumalanga, South Africa. Design. An open-label, in vivo therapeutic efficacy study of patients with uncomplicated P. falciparum malaria treated with a single oral dose of SP, with response to treatment monitored clinically and parasitologically on days 1, 2, 3, 7, 14, 21, 28 and 42. Setting. Mangweni and Naas public health care clinics, Tonga district in rural Mpumalanga. Subjects, outcome measures and results. Of 152 patients recruited sequentially, 149 (98%) were successfully followed up for 42 days. One hundred and thirty-four patients (90%) demonstrated adequate clinical and parasitological response. Of the 15 patients (10%) who failed treatment, 2 (1.3%) had an early treatment failure, and polymerase chain reaction confirmed recrudescent infection in all 13 patients (8.7%) who had late parasitological (N = 11) or clinical (N = 2) failure. Gametocyte carriage was prevalent following SP treatment (84/152) and this has increased significantly since implementation in 1998 (relative risk 2.77 (confidence interval 1.65 - 4.66); p = 0.00004). Conclusion. Asexual P. falciparum parasites in Mpumalanga remain sensitive to SP, with no significant difference between the baseline cure rate (94.5%) at introduction in 1998, and the present 90% cure rate (p = 0.14). However, since gametocyte carriage has increased significantly we recommend that SP be combined with artesunate in Mpumalanga to reduce gametocyte carriage and thus decrease malaria transmission and potentially delay antimalarial resistance.
dc.identifier.apacitationMabuza, A., Govere, J., La Grange, K., Mngomezulu, N., Allen, E., Zitha, A., ... Barnes, K. (2005). Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa. <i>South African Medical Journal</i>, 95(5), 346 - 349. http://hdl.handle.net/11427/34865en_ZA
dc.identifier.chicagocitationMabuza, Aaron, John Govere, Kobus La Grange, Nicros Mngomezulu, Elizabeth Allen, Alpheus Zitha, Frans Mbokazi, David Durrheim, and Karen Barnes "Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa." <i>South African Medical Journal</i> 95, 5. (2005): 346 - 349. http://hdl.handle.net/11427/34865en_ZA
dc.identifier.citationMabuza, A., Govere, J., La Grange, K., Mngomezulu, N., Allen, E., Zitha, A., Mbokazi, F. & Durrheim, D. et al. 2005. Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa. <i>South African Medical Journal.</i> 95(5):346 - 349. http://hdl.handle.net/11427/34865en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Mabuza, Aaron AU - Govere, John AU - La Grange, Kobus AU - Mngomezulu, Nicros AU - Allen, Elizabeth AU - Zitha, Alpheus AU - Mbokazi, Frans AU - Durrheim, David AU - Barnes, Karen AB - Objectives. To assess the therapeutic efficacy of sulfadoxine-pyrimethamine (SP) after 5 years of use as first-line treatment of uncomplicated Plasmodium falciparum malaria, and thus guide the selection of artemisinin-based combination therapy in Mpumalanga, South Africa. Design. An open-label, in vivo therapeutic efficacy study of patients with uncomplicated P. falciparum malaria treated with a single oral dose of SP, with response to treatment monitored clinically and parasitologically on days 1, 2, 3, 7, 14, 21, 28 and 42. Setting. Mangweni and Naas public health care clinics, Tonga district in rural Mpumalanga. Subjects, outcome measures and results. Of 152 patients recruited sequentially, 149 (98%) were successfully followed up for 42 days. One hundred and thirty-four patients (90%) demonstrated adequate clinical and parasitological response. Of the 15 patients (10%) who failed treatment, 2 (1.3%) had an early treatment failure, and polymerase chain reaction confirmed recrudescent infection in all 13 patients (8.7%) who had late parasitological (N = 11) or clinical (N = 2) failure. Gametocyte carriage was prevalent following SP treatment (84/152) and this has increased significantly since implementation in 1998 (relative risk 2.77 (confidence interval 1.65 - 4.66); p = 0.00004). Conclusion. Asexual P. falciparum parasites in Mpumalanga remain sensitive to SP, with no significant difference between the baseline cure rate (94.5%) at introduction in 1998, and the present 90% cure rate (p = 0.14). However, since gametocyte carriage has increased significantly we recommend that SP be combined with artesunate in Mpumalanga to reduce gametocyte carriage and thus decrease malaria transmission and potentially delay antimalarial resistance. DA - 2005 DB - OpenUCT DP - University of Cape Town IS - 5 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2005 SM - 0038-2469 T1 - Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa TI - Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa UR - http://hdl.handle.net/11427/34865 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34865
dc.identifier.vancouvercitationMabuza A, Govere J, La Grange K, Mngomezulu N, Allen E, Zitha A, et al. Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa. South African Medical Journal. 2005;95(5):346 - 349. http://hdl.handle.net/11427/34865.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Clinical Pharmacology
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue5
dc.source.journalvolume95
dc.source.pagination346 - 349
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.1652
dc.subject.otherAntimalarial
dc.subject.otherParasiticide
dc.subject.otherAntiinfectious
dc.subject.otherAntibacterial agent
dc.subject.otherHuman
dc.subject.otherChemotherapy
dc.subject.otherTreatment
dc.subject.otherTropical medicine
dc.subject.otherDrug combination
dc.subject.otherPlasmodium falciparum
dc.subject.otherMalaria
dc.subject.otherPyrimethamine
dc.subject.otherSulfadoxine
dc.subject.otherMpumalanga
dc.subject.otherSulfonamide
dc.subject.otherSulfanilamide derivatives
dc.subject.otherProtozoa
dc.subject.otherApicomplexa
dc.subject.otherInfection
dc.subject.otherParasitosis
dc.subject.otherProtozoal disease
dc.subject.otherAfrica
dc.titleTherapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria : A study 5 years after implementation of combination therapy in Mpumalanga, South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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