Evaluation of efficacy and tolerance of amodiaquine versus chloroquine treatment on children with umcomplicated P-falciparum malaria in Gabon

We conducted a prospective study from September 1997 to January 1998 in Lib reville (Gabon). Fifty-three (53) children with uncomplicated P. falciparum malaria were included and divided into two groups. The first group (27 pat ients) was treated with amodiaquine and the second (26 patients) with chlor oquine. The efficacy and tolerance of amodiaquine 30 mg/kg base over 3 days (10 mg/kg daily) and chloroquine 25 mg/kg base over 3 days (10 mg/kg day 0 , 10 mg/kg day 1, 5 mg/kg day 3) were estimated at days 7 and 14. Clinical examination and parasitaemia were assessed on days 0, 1, 2, 3, 7, 14. Haema tological and biochemical parametres were determined on days 0 and 7. Amodi aquine was shown to be more effective than chloroquine in clinical response and ridding patients of parasites. adequate clinical response was signific antly higher with amodiaquine than chloroquine [100% (27/27) versus 45% (91 20), p < 0,0005]. Rates for early treatment failure (ETF) and late treatmen t failure (LTF) were respectively 35% and 12% with chloroquine. The parasit ological success rate was significantly higher with amodiaquine than chloro quine on days 7 [93% (25/27) versus 62% (13/21), p < 0.008] and 14 [100% (1 3/13) versus 44% (4/9), p < 0,01]. The RI resistance type was 7% in the amo diaquine group, The rate of in vivo chloroquino-resistance was 53%, essenti ally of RII and RIII type. Overall, the two drugs were well tolerated.