Sulfadoxine-pyrimethamine for the treatment of Plasmodium falciparum malaria in Gabonese children

Chloroquine can no longer be recommended as the first-line treatment for fa lciparum malaria in several parts of Africa, given the increasing resistanc e of Plasmodium falciparum to this drug. The sulfadoxine-pyrimethamine comb ination (SP) is obviously an alternative candidate, that has already been s elected as first-line antimalarial treatment by a few African countries. Ho wever, the extent of resistance to SP appears to be highly variable within Africa. Therefore, we investigated the efficacy of SP to treat uncomplicate d malaria attacks in children from south-east Gabon. Sixty-six children pre senting with a P. falciparum malaria attack were given a standard regimen o f SP, and were followed at Days 3, 7, 14, and 21. No RIII response was obse rved, but relatively high prevalences of RII (18.2%) and RT (12.1%) were pr esent. Moreover, analysis of the clinical outcome according to CDC criteria showed that initial clinical response was lacking in 8.5% of children, and that clinical failure occurred in 9.1%.